慢性心力衰竭患者血浆内脏脂肪素水平及其影响因素的研究

2014-04-13邱樑姚琪陶袁全军民

浙江医学 2014年6期

邱樑　姚琪　陶袁　全军民

●临床研究

慢性心力衰竭患者血浆内脏脂肪素水平及其影响因素的研究

邱樑姚琪陶袁全军民

目的观察慢性左心衰竭患者的血浆内脏脂肪素水平，探讨其与糖脂代谢参数和高敏C反应蛋白（hs-CRP）的关系。方法将50例慢性左心功能不全患者（心力衰竭组）根据超声心动图左心室射血分数（LVEF）分成两亚组：轻度心功能不全亚组（35%＜LVEF≤45%）25例,重度心功能不全亚组（LVEF≤35%）25例；对照组（LVEF＞50%）24例，检测并比较各组hs-CRP、内脏脂肪素、血脂、血糖等指标。结果心力衰竭组内脏脂肪素较对照组降低（5.8±22.1 ng/ml vs 8.5±2.4 ng/ml，P＜0.01）；轻度、重度心功能不全亚组及对照组比较，内脏脂肪素、hs-CRP、血糖、HOMAIR、HDL-C差异均有统计学意义（P＜0.05或0.01）；内脏脂肪素与LVEF呈正相关（r=0.49，P＜0.01），与hs-CRP呈负相关（r=-0.30，P＜0.01）。结论心力衰竭患者的血清内脏脂肪素显著降低，此结果独立于年龄、性别、BMI和代谢参数。

内脏脂肪素心功能衰竭高敏C反应蛋白

【 Abstract】 ObjectiveTo determine the serum visfatin levels in patients with chronic heart failure(CHF)and its influencing factors.MethodsFifty patients with chronic heart failure due to left ventricular systolic dysfunction were divided into mild HF group(35%＜LVEF≤45%,n=25)and severe HF group(LVEF≤35%,n=25);24 healthy subjects(LVEF＞50%)served as control group.Serum visfatin,hsCRP,glucose and lipid metabolism parameters were measured in all subjects.ResultsSerum visfatin levels in HF groups were significantly lower than those in control group(5.8±22.1ng/ml vs 8.5±2.4ng/ml,P＜0.01).The Kruskal-Wallis test showed significant differences among three groups in serum levels of visfatin,hsCRP,glucose,HOMAIR and HDL-cholesterol(P＜0.05 or 0.01).Serum visfatin level was positively correlated with LVEF and negatively correlated with hs-CRP (r=0.49,-0.30，P＜0.01).ConclusionSerum visfatin levels in patients with systolic HF are decreased,which is independent to age,sex,BMI,and metabolic parameters of patients.

【 Key words】 VisfatinHeart failureHigh sensitivity C-reactive protein

心力衰竭是所有心脏疾病发展到后期的共同归宿，与全身低度炎症以及代谢异常相关，有较高的发病率及病死率。内脏脂肪素是一种主要由内脏脂肪细胞分泌的新型脂肪因子[1]，被认为是一种炎症性细胞因子[2]。以往有一些其他脂肪因子水平（如瘦素、apelin等）与心力衰竭严重程度之间关系的报道[3-4]。近年来对内脏脂肪素的研究越来越多，但有关内脏脂肪素与心力衰竭的关系的报道较少。本研究旨在观察左心衰竭患者的内脏脂肪素水平，及其与糖脂代谢参数和高敏C反应蛋白（hs-CRP）水平的关系，现报道如下。