中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
19期
8569-8572
,共4页
唐关敏%汪世军%胡惠林%朱良枫%陈浩%王华伟%徐文博%祝玉娟%王志勇%金丹丹%丁韧烨
唐關敏%汪世軍%鬍惠林%硃良楓%陳浩%王華偉%徐文博%祝玉娟%王誌勇%金丹丹%丁韌燁
당관민%왕세군%호혜림%주량풍%진호%왕화위%서문박%축옥연%왕지용%금단단%정인엽
心力衰竭%NYHA分级%Apelin12%Apelin13
心力衰竭%NYHA分級%Apelin12%Apelin13
심력쇠갈%NYHA분급%Apelin12%Apelin13
Heart failure%NYHA classification%Apelin12%Apelin13
目的：研究未经系统治疗、不同心功能阶段的慢性心力衰竭（CHF）患者血浆脂肪因子Apelin12和Apelin13的水平，探索Apelin在不同心功能状态下的表达差异及相关临床意义和机制。方法选取未经系统治疗、不同心功能阶段的CHF患者186例，分为心衰早期组86例（NYHA心功能分级Ⅰ～Ⅱ级）、心衰晚期组100例（NYHA心功能分级Ⅲ～Ⅳ级）；另选健康体检人员30例作对照组。CHF组在治疗前、对照组在体检时抽取空腹外周血，用酶联免疫吸附试验法（ELISA）测定外周血浆Apelin12和Apelin13水平，常规方法测定血脂水平，放射免疫法测定血浆NT-proBNP，心脏彩色多普勒超声测定LVIDd及EF，对检测结果进行统计学检验及相关性分析。结果 CHF患者Apelin12、Apelin13总体平均值和对照组比较无统计学差异（P＞0.05），但心衰早期组分别高于对照组（P＜0.05）和心衰晚期组（P＜0.01），心衰晚期组低于对照组（P＜0.05），晚期心衰组随心功能的下降Apelin表达水平呈明显下降；多因素回归分析提示不同心功能阶段CHF患者Apelin12、Apelin13表达与EF呈正相关（P＜0.05），而与LVIDd、NT-proBNP呈负相关（P＜0.05），与年龄、血脂水平无明显相关性。结论不同心功能阶段且未经治疗的 CHF 患者血浆Apelin12、Apelin13水平有明显差异，心衰早期Apelin明显升高，心衰晚期则明显下降并且低于对照组，在早、晚期心力衰竭患者中Apelin表达的差异可能是适应心脏功能改变的结果；检测血浆Apelin12、Apelin13水平可作为一种观察CHF心功能状况和预后的辅助指标。
目的：研究未經繫統治療、不同心功能階段的慢性心力衰竭（CHF）患者血漿脂肪因子Apelin12和Apelin13的水平，探索Apelin在不同心功能狀態下的錶達差異及相關臨床意義和機製。方法選取未經繫統治療、不同心功能階段的CHF患者186例，分為心衰早期組86例（NYHA心功能分級Ⅰ～Ⅱ級）、心衰晚期組100例（NYHA心功能分級Ⅲ～Ⅳ級）；另選健康體檢人員30例作對照組。CHF組在治療前、對照組在體檢時抽取空腹外週血，用酶聯免疫吸附試驗法（ELISA）測定外週血漿Apelin12和Apelin13水平，常規方法測定血脂水平，放射免疫法測定血漿NT-proBNP，心髒綵色多普勒超聲測定LVIDd及EF，對檢測結果進行統計學檢驗及相關性分析。結果 CHF患者Apelin12、Apelin13總體平均值和對照組比較無統計學差異（P＞0.05），但心衰早期組分彆高于對照組（P＜0.05）和心衰晚期組（P＜0.01），心衰晚期組低于對照組（P＜0.05），晚期心衰組隨心功能的下降Apelin錶達水平呈明顯下降；多因素迴歸分析提示不同心功能階段CHF患者Apelin12、Apelin13錶達與EF呈正相關（P＜0.05），而與LVIDd、NT-proBNP呈負相關（P＜0.05），與年齡、血脂水平無明顯相關性。結論不同心功能階段且未經治療的 CHF 患者血漿Apelin12、Apelin13水平有明顯差異，心衰早期Apelin明顯升高，心衰晚期則明顯下降併且低于對照組，在早、晚期心力衰竭患者中Apelin錶達的差異可能是適應心髒功能改變的結果；檢測血漿Apelin12、Apelin13水平可作為一種觀察CHF心功能狀況和預後的輔助指標。
목적：연구미경계통치료、불동심공능계단적만성심력쇠갈（CHF）환자혈장지방인자Apelin12화Apelin13적수평，탐색Apelin재불동심공능상태하적표체차이급상관림상의의화궤제。방법선취미경계통치료、불동심공능계단적CHF환자186례，분위심쇠조기조86례（NYHA심공능분급Ⅰ～Ⅱ급）、심쇠만기조100례（NYHA심공능분급Ⅲ～Ⅳ급）；령선건강체검인원30례작대조조。CHF조재치료전、대조조재체검시추취공복외주혈，용매련면역흡부시험법（ELISA）측정외주혈장Apelin12화Apelin13수평，상규방법측정혈지수평，방사면역법측정혈장NT-proBNP，심장채색다보륵초성측정LVIDd급EF，대검측결과진행통계학검험급상관성분석。결과 CHF환자Apelin12、Apelin13총체평균치화대조조비교무통계학차이（P＞0.05），단심쇠조기조분별고우대조조（P＜0.05）화심쇠만기조（P＜0.01），심쇠만기조저우대조조（P＜0.05），만기심쇠조수심공능적하강Apelin표체수평정명현하강；다인소회귀분석제시불동심공능계단CHF환자Apelin12、Apelin13표체여EF정정상관（P＜0.05），이여LVIDd、NT-proBNP정부상관（P＜0.05），여년령、혈지수평무명현상관성。결론불동심공능계단차미경치료적 CHF 환자혈장Apelin12、Apelin13수평유명현차이，심쇠조기Apelin명현승고，심쇠만기칙명현하강병차저우대조조，재조、만기심력쇠갈환자중Apelin표체적차이가능시괄응심장공능개변적결과；검측혈장Apelin12、Apelin13수평가작위일충관찰CHF심공능상황화예후적보조지표。
Objective Determining plasma levels of Apelin 12 and Apelin 13 in NYHA class I-IV CHF patients without medical treatment, to study the difference of Apelin in vary cardiac function and the possible mechanism and clinical signification. Methods 186 CHF patients (86 in CHF early stage NYAHⅠ-Ⅱ,100 in CHF end stage NYAH Ⅲ-Ⅵ) without hospital medical treatment and 30 normal controls were studied. Plasma Apelin12 and Apelin13 levels were measured by enzyme linked immunosorbent assay (ELISA), plasma lipid, NT-proBNP, EF and LVIDd were measured by radioimmunoassay and echocardiography respectively. Statistic analysis was used to determine the significances of differences and correlations. Results There was not significant statistical difference in Apelin12 and Apelin13 average level between CHF group and control group(P>0.05), however, Apelin12 and Apelin13 were significantly higher in CHF early stage group comparing to those in control group(P<0.05), and in end stage group (P<0.01). In addition, lower Apelin12 and Apelin13 were found in end stage group comparing to that in normal control (P<0.05). Then Apelin12 and Apelin13 decreased with depressed cardiac function, and showing a positive correlation with EF (P<0.05), and a negative correlation in LVEDd (P<0.05),and a negative correlation in NT-proBNP(P<0.05). There was not significant correlation was found between Apelins and age, gender as well as plasma lipid. Conclusions Plasma levels of Apelin12 and Apelin13 are significant differences in patient with untreated chronic heart failure classified by NYHA grading. Apelin was increased in early-stage of CHF, and decreased in end-stage of CHF, indicating that these changes may depend on cardiac function. Plasma Apelin12, Apelin13 levels could be monitored as indicators for determining cardiac function in CHF patients.
