慢性肺心病右心功能不全患者血清脂联素浓度的观察  

Serum adiponectin level in patients of chronic pulmonary heart disease with cardiac failure

作　　者：石慧芳[1] 丁毅鹏[2] 何海武[1] 

机构地区：[1]海南省农垦总局医院呼吸内科 ,海口570311 [2]海南省人民医院急救中心

出　　处：《中华医学杂志》2008年第36期2544-2546,共3页National Medical Journal of China

基　　金：海南省自然科学基金资助项目（2004-396-80464）

摘　　要：目的研究慢性肺心病右心功能不全患者血清脂联素浓度的变化及临床意义。方法采用酶联免疫吸附试验测定38例慢性肺心病右心功能不全失代偿期患者（心功能不全组）治疗前和治疗第2周末（治疗后分为缓解组、未缓解组）血清脂联素、白细胞介素6（IL-6）及肿瘤坏死因子α（TNF-α）浓度，以30名健康成人为对照（正常对照组）。结果心功能不全组、缓解组（32例）、未缓解组（6例）和正常对照组血清脂联素浓度（ng／L）分别为9．5±7．1、17．0±6．3、8．1±4．8和21．5±9．0，IL-6浓度（ng／L）分别为50．0±17．6、29．0±12．1、56．0±16．0和24．4±9．1，TNF—α浓度（ng／L）分别为53．8±16．2、32．3±13．5、59．3±19．1和28．4±11．4，心功能不全组血清脂联素浓度明显低于而IL-6和TNF-α浓度明显高于正常对照组（均P〈0．01）；缓解组血清脂联素浓度虽然仍低于正常对照组（P〈0．05），但明显高于未缓解组（P〈0．01），IL-6和TNF—α浓度则均明显低于未缓解组（均P〈0．01），与正常对照组差异无统计学意义；未缓解组3项指标均无明显变化。结论慢性肺心病右心功能不全失代偿期患者血清脂联素浓度降低，这可能与长期慢性缺氧、代谢异常及全身性炎症反应有关。动态监测血清脂联素浓度可能对临床指导肺心病心力衰竭治疗和判断预后有所帮助。Objective To investigate the changes of the concentration of serum adiponectin in patients of chronic pulmonary heart disease （CPHD） with cardiac failure. Methods Thirty-eight CPHD patients with cardiac failure underwent conventional treatment, and were divided into 2 subgroups ： remission subgroup （n = 32） and non-remission subgroup （ n = 6） according to the therapeutic effects 2 weeks later. Peripheral blood samples were collected from these 38 CPHD patients （CPHD group ）, including the remission subgroup and non-remission subgroup, and 30 healthy persons （as normal control group）. Enzyme linked immunosorbent assay（ELISA） was used to detect the serum levels of adiponectin, interleukin（IL）-6, and tumor necrosis factor （TNF）-α before and 2 weeks after treatment. Results The serum adiponectin of the CPHD group was （9.5 ±7. 1 ） ng/L in general, significantly lower than that of the normal control group [ （21.5 ± 9. 0） ng/L, P 〈 0. 01 ]. The serum adiponectin of the remission group was （ 17. 0 ± 6. 3 ） ng/L, significantly higher than that of the non-remission group [ （ 8. 1 ± 4. 8 ） ng/L, P 〈 0. 01 ], but still significantly lower than that of the normal control group （ P 〈 0. 05 ）. The IL-6 and TNF-α levels of the CPHD group were （50. 0 ± 17.6） and （53.8 ± 16. 2） ng/L respectively, both significantly higher than those of normal control group [ （24.4 ± 9. 1 ） and （ 28.4 ± 11.4 ） ng/L respectively, both P 〈 0. 01 ]. The IL-6 and TNF-α levels of the remission group were （ 29.0 ± 12. 1 ） ng/L and （ 32. 3 ± 13.5 ） ng/L respectively, both significantly lower than those of the non-remission group [ （56. 0 ± 16. 0） and （59. 3 ± 19. 1 ） ng/L respectively, both P 〈 0. 01 ] , but not significantly different from those of the normal control group. There were no significant differences in the adiponectin, IL-6, and TNF-α levels between the non-remission group and the CPHD group. Conclusions Adiponectin is involved in t

关 键 词：脂联索 肺心病 心力衰竭 充血性 

分 类 号：R686[医药卫生—骨科学]