糖尿病心脏病患者血浆心肌营养素-1水平与心功能的关系

目的 探讨糖尿病心脏病患者血浆心肌营养素-1（CT-1）的变化及与心功能的关系.方法 应用BSA-ELISA法测定健康对照者、2型糖尿病患者及糖尿病心脏病患者血浆CT-1水平,观察其与心功能的关系.结果 三组间血浆CT-1水平差异均有统计学意义（均P＜0.05）,糖尿病心脏病组血浆CT-1水平均显著高于2型糖尿病组及对照组（均P＜0.01）;2型糖尿病组高于对照组（P＜0.01）.糖尿病心脏病患者随着心功能的下降,血浆CT-1浓度逐步升高.血浆CT-1水平与左室射血分数（r=0.669,P＜0.01）、左心房内径（r=0.528,P＜0.01）、二尖瓣E峰流速（r=0.502,P＜0.01）、磷酸肌酸同工酶（r=0.312,P＜0.01）、甘油三酯（r=0.187,P＜0.05）、舒张压（r=0.158,P＜0.05）相关;多元逐步回归分析发现影响血浆CT-1水平的最显著因素为左室射血分数、左心房内径.结论 血浆CT-1浓度是反映糖尿病心脏病心衰严重程度的敏感指标,有助于糖尿病心脏病的早期诊断.

Clinical research on correlation between CT-1 and cardiac function in patients with diabetic cardiopathy

Objective To study the eorrelation between the plasma cardiotrophin-1(CT-1)level and cardiac function of patients with diabetic cardiopathy.Methods Using the Biotin-StreptAvidin-enzyme-linked immunosorbent assay(BSA-ELISA),the level of plasma CT-1 jn 35 normal controls,40 patients with type 2 diabetes and 60 patients with diabetic cardiopathy was measured.The relation to heart function was observed.Results The difference of plasma CT-1 level in the three groups was significant(all P＜0.05).The level of plasma CT-1 in diabetic cardiopathy group was apparently higher than that of type 2 diabetes group and normal controls(all P＜0.01);The level in type 2 diabetes group was significantly higher than that of normal controls(P＜0.01).The level of plasma CT-1 elevated with the worsening of heart failure(NYHA classification).The level of plasma CT-1 was correlated with EF(r=0.669,P＜0.01);LAD(r=0.528,P＜0.01);PVE(r=0.502,P＜0.01);CK-MB(r=0.312,P＜0.01);TG(r=0.187,P＜0.05);DBP(r=0.158,P＜0.05)o Stepwise regression analysis revealed that EF and LAD were the most significant agents affecting the plasma CT-1.Conclusion The plasma CT-1 level could reflect the state of cardiac function of diabetic cardiopathy patient,it could help to diagnose diabetic cardiopathy earlier.