心房颤动伴心功能不全患者脂联素的变化  

Adiponectin is associated with severity of ventricular dysfunction in atrial fibrillation patients with congestive heart failure

作　　者：李洁琪[1] 彭红[1] 杨红萍[1] 张荣先[1] 李屏[1] 周开碧[1] 赵全敏[1] 雷天琼 

机构地区：[1]贵阳医学院附属医院心内科,贵阳550004 [2]贵州省遵义市红花岗区计划生育服务站,550052

出　　处：《广东医学》2015年第3期379-381,共3页Guangdong Medical Journal

基　　金：贵州省优秀青年科技人才计划项目(编号:黔科合人字(2011)25号)

摘　　要：目的探讨心房颤动(房颤)伴心功能不全患者血浆脂联素(APN)水平的变化。方法 144例房颤患者依据纽约心脏病学会(NYHA)心功能分级标准分为心功能Ⅰ级、Ⅱ级、Ⅲ级和Ⅳ级。所有患者均由专人进行超声心动图检查测定左心房内径(LAD)、左心室舒张末内径(LVEDD)和左心室射血分数(LVEF),分别采用生化分析仪和酶联免疫吸附试验测定血浆N末端B型脑利钠肽原(NT-pro BNP)和APN水平。结果心功能Ⅱ级、Ⅲ级、Ⅳ级的房颤患者APN、NT-pro BNP、LVEDD、LAD与心功能Ⅰ级的房颤患者相比均明显升高,差异有统计学意义(P<0.05),并随NYHA心功能分级增加而升高;而LVEF明显下降(P<0.05),随NYHA心功能分级增加而降低。相关分析显示,NT-pro BNP与LAD(r=0.33,P=0.036)、LVEDD(r=0.512,P=0.006)存在明显正相关,与LVEF呈负相关(r=-0.41,P=0.001)。APN与NT-pro BNP(r=0.49,P=0.0002)、LVEDD(r=0.39,P=0.001)呈正相关,与LVEF呈负相关(r=-0.55,P=0.001),与LAD无关(r=0.12,P>0.05)。结论房颤合并心功能不全患者APN、NT-pro BNP、LVEDD、LAD、LVEF均随NYHA心功能分级增加而逐级变化,提示APN水平升高可能与心肌重构及房颤患者的预后有关。Objective To evaluate of the value of plasma adiponectin （ APN） in diagnosing heart failure in pa-tients with atrial fibrillation.Methods A total of 144 patients with atrial fibrillation were divided into 4 group, NYHA class Ⅰ group, Ⅱ group, Ⅲ group and Ⅳ group.LVEDD, LAD and LVEF were detected by transesophageal echocardio -graphy.Plasma APN level were measured by enzyme -linked immunosorbent assay （ELISA）.Results The plasma APN level, NT -proBNP, LVEDD and LAD in atrial fibrillation patients with NYHA class Ⅱ group, Ⅲ group and Ⅳ group were significantly higher than those in NYHA class Ⅰ group （P ＆lt;0.05）, and the differences were gradually increased with the increase of NYHA grading; and the LVEF was significantly per contra （P ＆lt;0.05）.According to correlation anal-ysis, NT -proBNP was significantly correlated with LAD （r =0.33, P =0.036）, LVEDD （r =0.512, P =0.006） and LVEF （r =-0.41, P =0.001）; and plasma APN was significantly positively correlated with NT -proBNP （r =0.49,P=0.000 2） and LVEDD （r =0.39, P =0.001）, while negatively correlated with LVEF （r =-0.55, P =0.001）.How-ever, no significant correlation was revealed between APN and LAD （r =0.12, P ＆gt;0.05）.Conclusion Plasma APN, NT -proBNP, LVEDD, LAD and LVEF are gradually changed as the progression of cardiac function in atrial fibrillation patients with heart failure, suggesting the increase of APN is correlated with the myocardial remodeling and prognosis .

关 键 词：脂联素 心房颤动 心功能不全 N 末端 B 型脑利钠肽原 超声心动图 

分 类 号：R541[医药卫生—心血管疾病]