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)
2015年
9期
1509-1513
,共5页
心力衰竭%恶病质%瘦素%基因多态性
心力衰竭%噁病質%瘦素%基因多態性
심력쇠갈%악병질%수소%기인다태성
Heart failure%Cachexia%Leptin%Gene polymorphism
目的：探讨扩张型心肌病合并恶病质患者血清瘦素水平的变化，并从基因水平探讨其变化的原因，初步阐明心力衰竭恶病质的发生机制，为其治疗寻求新靶点。方法收集2012～2014年就诊于包头医学院第一附属医院，确诊为扩张型心肌病、心功能（NYHA）Ⅱ～Ⅳ级患者56例。根据体重下降程度分为心力衰竭恶病质（cCHF）组（n=24）和心力衰竭非恶病质（ncCHF）组（n=32）。于住院的第二天，采集空腹静脉血5 ml，经RFLP-PCR检测血液瘦素G-2548A基因型表达，并经ELISA法检测血清中瘦素的水平。结果 cCHF患者较ncCHF患者血清瘦素水平降低，差异有统计学意义（P＜0.05）；在所有入选者中瘦素基因型AA型携带者瘦素水平高于AG型及GG型，差异有统计学意义（P＜0.05）；所有心力衰竭患者中AA型基因表达较AG型及GG型增高，cCHF患者AA型表达较ncCHF患者高，但差异无统计学意义（P＞0.05）；cCHF患者瘦素基因型 AA型体内LEP水平低于ncCHF患者，差异有统计学意义（P＜0.05）。结论瘦素G-2548A基因AA型与扩张型心肌病心力衰竭的发生相关。瘦素水平降低参与cCHF的发生，但与瘦素G-2548A基因多态性无关。
目的：探討擴張型心肌病閤併噁病質患者血清瘦素水平的變化，併從基因水平探討其變化的原因，初步闡明心力衰竭噁病質的髮生機製，為其治療尋求新靶點。方法收集2012～2014年就診于包頭醫學院第一附屬醫院，確診為擴張型心肌病、心功能（NYHA）Ⅱ～Ⅳ級患者56例。根據體重下降程度分為心力衰竭噁病質（cCHF）組（n=24）和心力衰竭非噁病質（ncCHF）組（n=32）。于住院的第二天，採集空腹靜脈血5 ml，經RFLP-PCR檢測血液瘦素G-2548A基因型錶達，併經ELISA法檢測血清中瘦素的水平。結果 cCHF患者較ncCHF患者血清瘦素水平降低，差異有統計學意義（P＜0.05）；在所有入選者中瘦素基因型AA型攜帶者瘦素水平高于AG型及GG型，差異有統計學意義（P＜0.05）；所有心力衰竭患者中AA型基因錶達較AG型及GG型增高，cCHF患者AA型錶達較ncCHF患者高，但差異無統計學意義（P＞0.05）；cCHF患者瘦素基因型 AA型體內LEP水平低于ncCHF患者，差異有統計學意義（P＜0.05）。結論瘦素G-2548A基因AA型與擴張型心肌病心力衰竭的髮生相關。瘦素水平降低參與cCHF的髮生，但與瘦素G-2548A基因多態性無關。
목적：탐토확장형심기병합병악병질환자혈청수소수평적변화，병종기인수평탐토기변화적원인，초보천명심력쇠갈악병질적발생궤제，위기치료심구신파점。방법수집2012～2014년취진우포두의학원제일부속의원，학진위확장형심기병、심공능（NYHA）Ⅱ～Ⅳ급환자56례。근거체중하강정도분위심력쇠갈악병질（cCHF）조（n=24）화심력쇠갈비악병질（ncCHF）조（n=32）。우주원적제이천，채집공복정맥혈5 ml，경RFLP-PCR검측혈액수소G-2548A기인형표체，병경ELISA법검측혈청중수소적수평。결과 cCHF환자교ncCHF환자혈청수소수평강저，차이유통계학의의（P＜0.05）；재소유입선자중수소기인형AA형휴대자수소수평고우AG형급GG형，차이유통계학의의（P＜0.05）；소유심력쇠갈환자중AA형기인표체교AG형급GG형증고，cCHF환자AA형표체교ncCHF환자고，단차이무통계학의의（P＞0.05）；cCHF환자수소기인형 AA형체내LEP수평저우ncCHF환자，차이유통계학의의（P＜0.05）。결론수소G-2548A기인AA형여확장형심기병심력쇠갈적발생상관。수소수평강저삼여cCHF적발생，단여수소G-2548A기인다태성무관。
Objective To investigate the change of serum level of leptin in dilated cardiomyopathy with cachexia patients, explore the reason from gene level, clarify the mechanism of cardiac cachexia patients preliminarily, and seek a new treatment target of chronic heart failure (CHF). Methods We enrolled 56 subjects with dilated cardiomyopathy from 2012 to 2014 treated in the first affiliated hospital of Baotou Medical College whose heart function were valued in NYHA classⅡtoⅣlevel, and 5 ml limosis intravenous blood was drew in the following day morning. All subjects were divided into cachexia chronic heart failure (cCHF) group (n=24) and non-cachetic chronic heart failure (ncCHF) group (n=32) according to the level of weight loss. Their DNA was isolated from whole blood and leptin DNA polymorphism was detected with RFLP-PCR. The level of leptin was determined with ELISA. Results The contents of serum level of leptin in cCHF group were all lower than those in ncCHF group, and differences were all significant (P<0.05). The serum level of leptin of AA genotype was higher than AG and GG genotype among all of the subjects and differences were all significant (P<0.05). The expression ratio of leptin AA genotype was higher than AG and GG genotype among all of the subjects, and the expression ratio of AA genotype was higher in cCHF group than ncCHF group, but the difference was not statistically significant. The serum level of leptin of AA genotype in cCHF group was lower than the other, and difference was significant (P<0.05). Conclusion AA genotype of leptin gene G-2548A was significantly correlated with dilated cardiomyopathy CHF. A lower level of leptin may involves in the occurrence of cCHF, but it was not related to G-2548A gene polymorphism.
