射血分数正常与射血分数下降心力衰竭脂联素水平的变化及意义

目的探讨血浆脂联素（adiponectin，APN）水平在射血分数正常心力衰竭（HFNEF）和射血分数下降心力衰竭（HFREF）患者中的变化及其与HFNEF患者预后的关系。方法检测90例HFREF患者和56例HFNEF患者血浆APN和氨基末端脑利钠肽前体（NT—proBNP）水平，行多普勒超声心动图检查，对所有出院患者进行随访，平均随访12个月（8-16个月），观察心血管事件（心力衰竭加重导致再入院和死亡）再发情况。结果血浆APN水平HFNEF组低于HFREF组，分别为（8．13±2．48）、（12．46±4．87）μg／ml，P=0．000；HFNEF组APN水平与NT—proBNP水平和左室质量指数（LVMI）呈正相关（r=0．868，P=0．000；r=0．350，P=0．000）；APN和NT—proBNP水平是HFNEF预后的独立预测因子（P=0．000；P=0．001）。结论HFNEF患者血浆APN水平低于HFREF患者，APN水平可能与NT—ProBNP联合起来成为预测HFNEF患者预后的特异性指标。

The Differences of Concentrations of Adiponectin in Patients of Heart Failure with Normal Ejection Fraction and Reduced Ejection Fraction

Objective To determine concentrations of adiponectin(APN) in patients of heart failure with normal ejection fraction(HFNEF) and with reduced ejection fraction(HFREF),determine its predictive value on outcome in patients with HFNEF.Methods Serum and clinical data were obtained for patients with HFNEF(n=56) and HFREF(n=90).Serum concentrations of APN,N-terminal pro-brain natriuretic peptide(NT-proBNP) were determined,doppler echocardiography were measured after admission.All discharged patients were followed ...