慢性心力衰竭患者血清网膜素、趋化素、vaspin与心肌重构及心功能的关系

目的探讨慢性心力衰竭(chronic heart failure,CHF)患者血清网膜素、趋化素、腹腔脂肪型丝氨酸蛋白酶抑制剂(vaspin)浓度及与心肌重构和心功能的相关性。方法选择辽宁省金秋医院心血管内科2017年1月至2019年3月收治的196例CHF患者为研究对象,按原发性心血管疾病分为高血压性心脏病52例,缺血型心肌病53例,扩张型心肌病44例,糖尿病型心肌病47例。选择同期健康体检人群68名作为对照组。采用酶联免疫吸附试验(ELISA)检测研究对象血清网膜素、趋化素、vaspin浓度及测定心功能相关指标。结果心功能Ⅳ级组患者血清网膜素、vaspin浓度均明显低于心功能Ⅲ级组、Ⅰ~Ⅱ级组、对照组(心功能Ⅳ级组<心功能Ⅲ级组<心功能Ⅰ~Ⅱ级组<对照组,P<0.05),血清趋化素浓度明显高于心功能Ⅲ级组、Ⅰ~Ⅱ级组、对照组(心功能Ⅳ级组>心功能Ⅲ级组>心功能Ⅰ~Ⅱ级组>对照组,P<0.05)。扩张型心肌病组患者血清网膜素、vaspin浓度均明显低于高血压性心脏病组、糖尿病型心肌病组、缺血型心肌病组(扩张型心肌病组<缺血型心肌病组<糖尿病型心肌病组<高血压性心脏病组,P<0.05),但血清趋化素浓度明显高于高血压性心脏病、糖尿病型心肌病、缺血型心肌病(扩张型心肌病组>缺血型心肌病组>糖尿病型心肌病组>高血压性心脏病,P<0.05)。心功能Ⅳ级组患者左心室重构指数(left ventricular remodeling index,LVRI)、左心室射血分数(left ventricular ejection fractions,LVEF)、心排血量(cardiac output,CO)明显低于心功能Ⅲ级组、Ⅰ~Ⅱ级组、对照组(对照组>心功能Ⅰ~Ⅱ级组>心功能Ⅲ级组>心功能Ⅳ级组,P<0.05),但左心室质量指数(left ventricular mass index,LVMI)、左心室舒张末内径(left ventricular end-diastolic dimension,LVEDD)、左心房内径(left atrial diameter,LAD)以及左心室后壁厚度(left ventricular posterior wall thickness,LVPW)均明显高于心功能Ⅲ级组、Ⅰ~Ⅱ级组、对照组(对照组<心功能Ⅰ~Ⅱ级组<心功能Ⅲ级组<心功能Ⅳ级组,P<0.05)。血清网膜素、vaspin与LVRI、LVEF、CO呈正相关(P<0.05),与LVMI、LVEDD、LAD、LVPW呈负相关(P<0.05);血清趋化素与LVRI、LVEF、CO呈负相关(P<0.05),与LVMI、LVEDD、LAD、LVPW呈正相关(P<0.05)。结论CHF患者血清网膜素、vaspin浓度降低,趋化素浓度升高,并随着患者病情的逐渐加重而降低或升高,与患者的心肌重构和心功能指标有着密切的关系。

Correlation between serum concentrations of omentin,chemerin,vaspin with myocardial remodeling and cardiac function in patients with chronic heart failure

Objectives To investigate the correlation between serum concentrations of omentin,chemerin,vaspin with myocardial remodeling and cardiac function in patients with chronic heart failure(CHF).Methods Totally 196 CHF patients and 68 cases of healthy examines(control group)admitted to cardiovascular department of Liaoning Golden Autumn Hospital from January 2017 to March 2019 were selected.Patients included 52 cases of hypertensive heart disease,53 cases of ischemic cardiomyopathy,44 cases of dilated cardiomyopathy and 47 cases of diabetic cardiomyopathy.Serum concentrations of omentin,chemerin,vaspin were measured by enzyme-linked immunosorbent assay(ELISA)as well as the cardiac function related indicators.Results Serum concentrations of omentin and vaspin were ranking in an ascending order of cardiac function grade Ⅳ groupcardiac function grade Ⅲ group>cardiac function grade Ⅰ-Ⅱ group>control group,with statistic difference(P<0.05).Serum concentration of omentin was the highest in the hypertensive heart disease and was the lowest in the dilated cardiomyopathy(P<0.05).Serum concentration of chemerin was the highest in dilated cardiomyopathy(P<0.05).Left ventricular remodeling index(LVRI),left ventricular ejection fractions(LVEF),cardiac output(CO)in cardiac function grade Ⅳ group were significantly lower than those in cardiac function grade Ⅲ,cardiac function gradeⅠ-Ⅱ group,control group(control group>cardiac function grade Ⅰ-Ⅱ group>cardiac function grade Ⅲ group>cardiac function grade Ⅳ group,P<0.05),but left ventricular mass index(LVMI),left ventricular end-diastolic dimension(LVEDD),left atrial diameter(LAD),left ventricular posterior wall thickness(LVPW)were significantly higher than those in cardiac function grade Ⅲ group,cardiac function grade Ⅰ-Ⅱ group and control group(control group