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目的探讨充血性心力衰竭(CHF)患者血浆脂联素(APN)、脑钠肽(BNP)水平的变化及临床意义。方法应用酶联免疫吸附法(ELISA)分别测定70例扩张型心肌病CHF患者治疗前、治疗后及20例正常人血浆APN和BNP水平,并进行统计学分析比较。结果①CHF组APN、BNP水平分别为(11.66±4.59)mg/L(、1079.78±550.76)ng/L明显高于正常对照组(1.38±0.47)mg/L、(59.63±22.43)ng/L(均P<0.01);②心功能Ⅱ、Ⅲ、Ⅳ级组APN分别为(5.59±1.85)mg/L、(11.27±3.00)mg/L及(15.19±3.81)mg/L,BNP水平分别为(463.78±169.50)ng/L、(917.05±290.19)ng/L及(1 595.72±481.76)ng/L,随着心功能恶化二者水平显著升高(均P<0.01)。③CHF组治疗后APN(5.88±2.55)mg/L、BNP(547.25±234.88)ng/L明显低于治疗前水平,(11.66±4.59)mg/L(、1 079.78±550.76)ng/L(均P<0.01);④CHF组血浆APN水平与BNP呈正相关(r=0.680,P<0.01)。结论 CHF患者血浆APN和BNP水平明显高于正常对照组且随着心功能恶化而显著升高。CHF患者经治疗后随心功能好转血浆APN和BNP水平可降低。CHF患者血浆APN和BNP呈正相关。
Objective To investigate the changes of plasma adiponectin (APN) and brain natriuretic peptide (BNP) in patients with congestive heart failure (CHF) and its clinical significance. Methods Serum levels of APN and BNP in 70 patients with dilated cardiomyopathy before and after treatment and in 20 normal subjects were measured by enzyme-linked immunosorbent assay (ELISA), and compared statistically. Results ① The levels of APN and BNP in CHF group were significantly higher than those in normal control group (11.66 ± 4.59) mg / L (1079.78 ± 550.76) ng / L and (59.3 ± 22.43) ng / L (P <0.01). The APN of groupⅡ, Ⅲ and Ⅳ were (5.59 ± 1.85) mg / L, (11.27 ± 3.00) mg / L and (15.19 ± 3.81) mg / L respectively (463.78 ± 169.50) ng / L, (917.05 ± 290.19) ng / L and (1595.72 ± 481.76) ng / L, respectively. ③ The APN in CHF group was significantly lower than that before treatment (5.88 ± 2.55 mg / L, BNP 547.25 ± 234.88 ng / L, 11.66 ± 4.59 mg / L, 1079.78 ± 550.76 ng / L, P <0.01) .④The level of plasma APN in CHF group was positively correlated with BNP (r = 0.680, P <0.01). Conclusion The levels of APN and BNP in plasma of CHF patients were significantly higher than those of normal controls and significantly increased with the worsening of cardiac function. CHF patients after treatment of cardiac function improved plasma APN and BNP levels can be reduced. There was a positive correlation between APN and BNP in CHF patients.