老年慢性心力衰竭患者血浆ghrelin浓度变化及意义研究  

Studies on the Changes of Concentration of Plasma Ghrelin in Elderly Patients with Chronic Congestive Heart Failure and Its Significances

作　　者：张维波[1] 傅强[1] 陈成[2] 陈景亮[1] 

机构地区：[1]福建医科大学附属福州市第一医院,福建福州350009 [2]福建省第二人民医院

出　　处：《中国医学创新》2016年第17期15-18,共4页Medical Innovation of China

基　　金：福建省卫生计生青年科研课题立项资助项目(2012-2-68)

摘　　要：目的:探讨老年慢性心力衰竭患者外周血血浆ghrelin浓度变化及其可能意义。方法:收集老年慢性心力衰竭患者88例,其中心功能Ⅱ级组33例,心功能Ⅲ级组29例,心功能Ⅳ级组26例,选择同期健康体检者30例为对照组。采用心脏彩色多普勒超声测定患者左室射血分数(LVEF),左室舒张末期内径(LVEDD)及左室收缩末期内径(LVESD);检测外周血浆N氨基末端脑钠肽前体NT-proBNP含量;测定外周血血浆ghreilin及血清INF-γ、IL-4、CRP浓度。分析血浆ghreilin浓度与LVEF、LVEDD、LVESD、NTpro-BNP、INF-γ、IL-4、CRP的相关关系。结果:随着心功能分级增加,血浆ghrelin、NTpro-BNP及血清INF-γ、CRP含量上升,各组比较差异均有统计学意义(P<0.05)。随着心功能分级增加,LVEF呈下降趋势,各组比较差异均有统计学意义(P<0.05)。随着心功能分级增加,LVEDD、LVESD呈增大趋势,心功能Ⅲ级、Ⅳ级组均比心功能Ⅱ级组增大,比较差异均有有统计学意义(P<0.05),但心功能Ⅲ级、Ⅳ级组间比较差异无统计学意义(P>0.05)。血清IL-4含量随着心功能分级增加呈下降趋势,心功能Ⅲ级、Ⅳ级组均比心功能Ⅱ级组下降,比较差异均有统计学意义(P<0.05),但心功能Ⅲ级、Ⅳ级组间比较差异均无统计学意义(P>0.05)。多元逐步回归法分析提示慢性心力衰竭患者血浆ghrelin浓度与INF-γ、IL-4、NT-proBNP、LVEF、LVEDD有独立相关关系(r=0.443、-0.412、0.377、-0.343、0.297,P<0.05)。结论:慢性心力衰竭患者心衰程度越重,血浆ghrelin浓度越高。慢性心力衰竭患者血浆ghrelin浓度与INF-γ、IL-4、NT-proBNP、LVEF、LVEDD有密切相关关系。Objective：To investigate the changes of concentration of plasma ghrelin in elderly patients with chronic congestive heart failure and the probable significances.Method：A total of 88 elderly patients with chronic congestive heart failure were enrolled,33 patients were classified as New York heart Association functional class Ⅱ,29 patients as class Ⅲ and 26 patients as class Ⅳ.30 patients were enrolled in control group.Colour Doppler echocardiography was performed to determine left ventricular ejection fraction（LVEF）,left ventricular end-diastolic diameter（LVEDD）,and left ventricular end systolic diameter（LVESD）.Plasma N-termial pro-brain natriuretic peptide（NT-proBNP） and ghrelin concentrations were analyzed,serum INF-γ,IL-4,CRP levels were determined.The correlation among plasma ghrelin concentration with LVEF,LVEDD,LVESD and the levels of NT-proBNP,INF-γ,IL-4,CRP in elderly patients were analyzed.Result：As rising of heart functional stage,plasma ghrelin and NT-proBNP concentrations ascended, serum INF-γ and CRP levels increased,there were statistics differences between every two groups（P〈0.05）.As rising of heart functional stage,LVEF declined,there were statistics differences between every two groups（P〈0.05）.As rising of heart functional stage,LVEDD and LVESD magnified,they were bigger in class Ⅲ,Ⅳ groups then that in class Ⅱ group（P〈0.05）,but there were no statistics differences between class Ⅲ group and class Ⅳgroup（P〈0.05）.As rising of heart functional stage,the levels of serum IL-4 declined,they were lower in class Ⅲ,Ⅳ groups then that in class Ⅱ group（P〈0.05）,but there were no statistics differences between class Ⅲ group and class Ⅳgroup（P〈0.05）.The results of the multiple linear regression pompted that there were independent relationships among plasma ghrelin concentrations with the levels of serum INF-γ,IL-4,plasma NT-proBNP,LVEF,LVEDD（r=0.443,-0.412,0.377,-0.343,0.297,P〈0.05）.Conclusion：The concentratons of pl

关 键 词：老年人 慢性心力衰竭 GHRELIN INF-Γ IL-4 

分 类 号：R541.6[医药卫生—心血管疾病]