充血性心力衰竭患者血清抵抗素、基质金属蛋白酶2及N端脑钠肽浓度的变化及其临床意义

目的 探讨充血性心力衰竭（CHF）患者血清抵抗素（Resistin）、基质金属蛋白酶2（MMP-2）和N端脑钠肽（NT-proBNP）浓度变化及其与左心功能的相关性。方法 选择CHF患者78例（CHF组）以及健康对照30例（对照组），测定其血清NT-proBNP、MMP-2、抵抗素浓度变化，同时经彩色心脏超声测定左心室功能参数：左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）、左心室射血分数（LVEF）和左心室短轴缩短率（LVFS），并分析其相关性。结果 CHF患者血清NT-proBNP、MMP-2、抵抗素浓度显著高于对照组（P＜0.05），并随心力衰竭程度的加重而显著增加（P＜0.05）；血清NT-proBNP、MMP-2、抵抗素与LVEDD、LVESD呈正相关，与LVEF、LVFS呈负相关（P均＜0.05）。结论 检测NT-proBNP、MMP-2和抵抗素浓度有助于CHF的早期诊断及其心力衰竭程度的判断。

Serum resistin, MMP2 and NT-ProBNP levels in patients with congestive heart failure

Objective    To study concentration changes of serum resistin, matrix metalloproteinases-2(MMP-2) and N-terminal fragment of the pro-peptide of brain natriuretic peptide (NT-ProBNP) in patients with congestive heart failure(CHF), and the relationship with the left ventricular function. Methods    78 CHF patients and 30 healthy controls were selected, and serum resistin and MMP-2 were detected by ELISA and NT-ProBNP with the electrochemistry luminescence method. Left ventricular function parameters were measured at the same time: left ventricular end-diastolic dimension(LVEDD), left ventricular end-systolic dimension(LVESD), left ventricular ejection fraction(LVEF) and left ventricular fractional shortening(LVFS). Results    Serum resistin, MMP-2 and NT-ProBNP levels in patients with CHF were higher than those in the healthy controls(P＜0.05), and evidently increased with cardiac function improvement(P＜0.05). Serum resistin, MMP-2 and NT-ProBNP levels were positively related with LVEDD and LVESD, negatively related with LVEF and LVFS(P＜0.05). Conclusion     Resistin, MMP-2 and NT-ProBNP play a very important role in CHF, and are useful in the early diagnosis and evaluation of cardiac function of CHF patients.