CAJ | 학술논문

目的：探讨内源性H2松弛素（H2RLX）在慢性心力衰竭患者中的表达以及与NYHA分级的关系，研究其对慢性心力衰竭患者预后的预测作用。方法：选取2012年7月至2012年12月住院患者140例，慢性心力衰竭组109例，对照组31例。2组患者均予入院第1天清晨平卧、静息状态下抽取静脉血以检测LDL-胆固醇、血红蛋白、空腹血糖、肌酐清除率、脑钠肽（BNP）等，用ELISA法检测血H2RLX、I型胶原的表达量，心脏超声评估左心室射血分数（LVEF）。结果：①慢性心力衰竭组血浆H2RLX水平[0.604（0.419～0.743）pg/mL]，与对照组[0.390（0.355～0.425）pg/mL]比较显著升高，差异有统计学意义（P＜0.05）；②NYHA分级越高，慢性心力衰竭组H2RLX和I型胶原升高趋势越显著，差异有统计学意义（P＜0.05）；③H2RLX与I型胶原呈显著正相关，差异有统计学意义（r=0.885，P＜0.001）；④H2RLX水平对慢性心力衰竭患者半年内心血管事件预后有预测作用。结论：慢性心力衰竭患者血浆中H2RLX表达升高，其可能参与心室纤维化过程；血浆H2RLX水平有助于慢性心力衰竭严重程度的评估，并对心血管事件的预后有预测作用。
목적：탐토내원성H2송이소（H2RLX）재만성심력쇠갈환자중적표체이급여NYHA분급적관계，연구기대만성심력쇠갈환자예후적예측작용。방법：선취2012년7월지2012년12월주원환자140례，만성심력쇠갈조109례，대조조31례。2조환자균여입원제1천청신평와、정식상태하추취정맥혈이검측LDL-담고순、혈홍단백、공복혈당、기항청제솔、뇌납태（BNP）등，용ELISA법검측혈H2RLX、I형효원적표체량，심장초성평고좌심실사혈분수（LVEF）。결과：①만성심력쇠갈조혈장H2RLX수평[0.604（0.419～0.743）pg/mL]，여대조조[0.390（0.355～0.425）pg/mL]비교현저승고，차이유통계학의의（P＜0.05）；②NYHA분급월고，만성심력쇠갈조H2RLX화I형효원승고추세월현저，차이유통계학의의（P＜0.05）；③H2RLX여I형효원정현저정상관，차이유통계학의의（r=0.885，P＜0.001）；④H2RLX수평대만성심력쇠갈환자반년내심혈관사건예후유예측작용。결론：만성심력쇠갈환자혈장중H2RLX표체승고，기가능삼여심실섬유화과정；혈장H2RLX수평유조우만성심력쇠갈엄중정도적평고，병대심혈관사건적예후유예측작용。
Objective: To explore the expression of endogenous H2 relaxin hormone in chronic heart failure patients, and the relations with NYHA classiifcation, to study its effect on the prognosis of patients with chronic heart failure prediction.Methods: One hundred and forty patients were selected for reseach from July 2012 to September 2012, in the First Afifliated Hospital of Wenzhou Medical University, 109 cases for chronic heart failure group and 31 cases for control group. In the early morning of the ifrst day after admission, patients in each group were exsanguinated in supine, resting status for some venous blood to detect, LDL-cholesterol, he-moglobin, fasting blood glucose, creatinine clearance rate, brain natriuretic peptide (BNP) and so on. ELISA was performed to analyze the plasma concentration of H2RLX, collagen I. In addition, echocardiography inspection was given to estimate left ventricular ejection fraction.Results:①Plasma H2RLX level of chronic heart failure patients [0.604 (0.419-0.743)] pg/mL was signiifcantly higher than that of control group [0.390 (0.355-0.425)] pg/mL. The difference was statistically signiifcant (P<0.05).②The tendency as classiifcation of NYHA showed that the plasma level of H2RLX and collagen I both increased in all of heart failure (HF) patients as aggravation of cardiac dysfunction. The difference was statistically signiifcant (P<0.05).③Plasma level of H2RLX and type I collagen showed signiifcant correlation, there was statistically signiifcant (r=0.889,P<0.001).④H2RLX levels in chronic heart failure patients could predict the cardiovascular event in one hundred and eighty days.Conclu-sion: The H2RLX levels elevate in patients with chronic heart failure, which may involve in ventricular ifbrosis; H2RLX may help to make preliminary estimation of the severity of chronic heart failure and H2RLX plasma lev-els may predict the prognosis of cardiovascular events.