慢性心力衰竭患者血浆可溶性ST2及APN水平变化及临床意义  

The Changes and Clinical Significance of Soluble ST2 and Adiponectin in Patient with Chronic Heart Failure

作　　者：郑红英[1] 赵梅[2] 朵银莉[1] 黄丽娟[1] 白芳芸[1] 陈璟[1] 陈孟[1] 杨锐英[3] 

机构地区：[1]宁夏医科大学总医院VIP病房,银川750004 [2]宁夏医科大学总医院医学实验中心,银川750004 [3]宁夏医科大学总医院心脏中心干部病房,银川750004

出　　处：《宁夏医科大学学报》2016年第11期-,共5页Journal of Ningxia Medical University

摘　　要：目的探讨慢性心力衰竭(chronic heart failure,CHF)患者血浆可溶性ST2蛋白(soluble ST2,s ST2)、脂联素(adiponectin,APN)水平的变化及临床意义。方法选取CHF患者(心衰组)99例,同时选取同期因冠心病、高血压病、糖尿病等住院的无心力衰竭的患者65例(前心衰阶段组32例,前临床心衰阶段组33例),另选取门诊健康体检者28例作为健康体检组。采用酶联免疫吸附法(ELISA)检测患者血浆中的s ST2、APN及B型利钠肽(B-type natriuretic peptide,BNP)水平,并分析s ST2、APN与BNP、左室射血分数(1eft ventricular ejection fraction,LVEF)、纽约心脏病学会(NYHA)心功能分级之间的相关性。结果 1)心衰组血浆s ST2、APN、BNP水平明显高于健康体检组、前心衰阶段组(P均<0.01),心衰组APN水平高于前临床心衰阶段组(P<0.01);2)血浆s ST2、APN、BNP水平在心功能Ⅱ、Ⅲ、Ⅳ级间差异有统计学意义(P均<0.01),且随着心功能分级的升高而逐渐增高(P均<0.05);3)Spearman相关分析显示,CHF患者血浆s ST2、APN与BNP、NYHA分级呈正相关(P均<0.01),与LVEF呈负相关(P均<0.01)。结论 CHF患者血浆s ST2、APN水平明显升高,与BNP及NYHA分级呈正相关,因此两者可以作为心衰患者临床诊断及病情评估的参考指标。Objective To investigate the changes and clinical significance of plasma soluble ST2(s ST2)protein and adiponectin(APN)protein in patient with chronic heart failure(CHF). Methods 99 inpatients with CHF were enrolled while 65 cases with coronary heart disease,hypertension,diabetes and without heart failure were divided into 32 cases of former stage heart failure group and 33 cases of preclinical stage heart failure group. 28 healthy examined outpatients were selected as healthy controls. Plasma levels of s ST2,APN and B-type natriuretic peptide(BNP)were determined by ELISA. s ST2,APN and BNP concentration difference among heart failure,without heart failure group and healthy control group were analyzed and the correlation between s ST2,APN and BNP,left ventricular ejection fraction(LVEF),the NYHA heart function classification were calculated.Results 1)plasma s ST2,APN,BNP levels of Heart failure group were significantly higher than those of healthy control group and former stage heart failure group(P<0.01). APN level of Heart failure group was significantly higher than that at the previous stage of clinical heart failure group(P<0.01). 2)Plasma s ST2,APN,BNP levels among different cardiac function Ⅱ,Ⅲ,Ⅳ level showed significantly different(P<0.01),and increased gradually along with the rise of cardiac function classification(P<0.05). 3) The Spearman correlation analysis showed that plasma s ST2,APN with CHF patients were significantly positively correlated with BNP,NYHAclassification(P<0.01),and they significantly negatively correlated with LVEF(P<0.01).Conclusion The plasma levels of s ST2 and APN in patients with CHF raised significantly and they were positively correlated with BNP and NYHA classification of cardiac function. s ST2 and APN can be used as reference indices for clinical diagnosis and assessment of CHF.

关 键 词：慢性心力衰竭 可溶性ST2 脂联素 心功能 

分 类 号：R541.6[医药卫生—心血管疾病]