CAJ | 학술논문

目的：检测不同心功能分级的慢性心力衰竭（CHF）患者和正常对照组外周血清Irisin （鸢尾素）的水平，研究Irisin在CHF中的临床价值。方法选自2013年1～7月在潍坊市人民医院心内科住院的CHF患者45例，并根据NYHA分级将患者分为三组，其中心功能Ⅱ级患者12例，心功能Ⅲ级患者15例，心功能Ⅳ级患者18例，另选年龄、性别、体质量指数（body mass index， BMI）相匹配的，且左心室射血分数（LVEF）＞50%的健康对照组20例。采用生物素双抗体夹心酶联免疫吸附（ELISA）测定血清 Irisin 水平，并完成心电图（ECG）、LVEF、空腹血糖、心功能等常规检查项目。比较健康对照组与心力衰竭组不同心功能分级及不同亚组间的 Irisin 差异，并对Irisin 与相关因素进行相关性分析。结果（1）4组受试者年龄、性别、BMI 比较，差异无统计学意义（P＞0.05），资料具有可比性。（2）心力衰竭组Irisin浓度显著低于健康对照组（P＜0.05），且在NYHA分级Ⅱ、Ⅲ和Ⅳ级患者中逐渐降低。（3）心力衰竭组的LVEF较健康对照组显著降低（P＜0.05），在NYHA心功能Ⅱ、Ⅲ、Ⅳ级间逐渐下降。（4）单因素相关分析显示：Irisin与LVEF呈正相关（r=0.694，P＜0.05）。结论（1）在CHF患者中血清Irisin浓度较健康对照组显著降低，且随着心功能NYHA分级严重程度的加重而逐渐降低，故可以作为CHF的血清生物标记物用于CHF的诊断及鉴别诊断，并为CHF的治疗提供了新的思路。（2）Irisin与LVEF呈正相关，可以反映心功能的情况。
목적：검측불동심공능분급적만성심력쇠갈（CHF）환자화정상대조조외주혈청Irisin （연미소）적수평，연구Irisin재CHF중적림상개치。방법선자2013년1～7월재유방시인민의원심내과주원적CHF환자45례，병근거NYHA분급장환자분위삼조，기중심공능Ⅱ급환자12례，심공능Ⅲ급환자15례，심공능Ⅳ급환자18례，령선년령、성별、체질량지수（body mass index， BMI）상필배적，차좌심실사혈분수（LVEF）＞50%적건강대조조20례。채용생물소쌍항체협심매련면역흡부（ELISA）측정혈청 Irisin 수평，병완성심전도（ECG）、LVEF、공복혈당、심공능등상규검사항목。비교건강대조조여심력쇠갈조불동심공능분급급불동아조간적 Irisin 차이，병대Irisin 여상관인소진행상관성분석。결과（1）4조수시자년령、성별、BMI 비교，차이무통계학의의（P＞0.05），자료구유가비성。（2）심력쇠갈조Irisin농도현저저우건강대조조（P＜0.05），차재NYHA분급Ⅱ、Ⅲ화Ⅳ급환자중축점강저。（3）심력쇠갈조적LVEF교건강대조조현저강저（P＜0.05），재NYHA심공능Ⅱ、Ⅲ、Ⅳ급간축점하강。（4）단인소상관분석현시：Irisin여LVEF정정상관（r=0.694，P＜0.05）。결론（1）재CHF환자중혈청Irisin농도교건강대조조현저강저，차수착심공능NYHA분급엄중정도적가중이축점강저，고가이작위CHF적혈청생물표기물용우CHF적진단급감별진단，병위CHF적치료제공료신적사로。（2）Irisin여LVEF정정상관，가이반영심공능적정황。
Objective To test the levels of peripheral blood Irisin in different heart function classification of patients with chronic heart failure (CHF) and normal control group, and evaluate Irisin diagnostic value in CHF. Methods From January 2013 to July 2013 collected 45 patients of chronic heart failure in my Department of Cardiology Weifang People's Hospital, and according to NYHA classification heart failure group were divided into 3 groups, 12 cases were cardiac function classⅡ, 15 patients cardiac function grade Ⅲ, 18 patients cardiac function level Ⅳ, another age, gender, body mass index (BMI) phase matching, and left ventricular ejection fraction (LVEF)>50%healthy control group of 20 cases were selected. Using biotinylated double antibody sandwich enzyme linked immunosorbent assay (ELISA) to determinate the serum Irisin level, and completed the electrocardiogram (ECG), LVEF, fasting blood glucose, heart function routine inspection project. Compared the difference of Irisin in healthy control group and heart failure group without classification of cardiac function and different sub groups, Irisin and related factors were analyzed. Results (1)Comparison of age, gender, BMI in 4 groups was no significant difference (P>0.05). (2)Irisin in heart failure group was significantly lower than that in healthy control group (P<0.05), and decreased gradually in NYHA grade Ⅱ, Ⅲ, Ⅳ level in patients. (3)LVEF in heart failure group than the healthy control group decreased significantly (P<0.05), decreased in cardiac functionin NYHAⅡ, Ⅲ, Ⅳ level. (4)Single factor correlation analysis showed that Irisin was positively correlated with LVEF (r=0.694, P<0.05). Conclusions (1)The concentration of serum Irisin in CHF patients than in the healthy control group decreased significantly, and decreased with the NYHA cardiac functional grading exacerbation severity, so it can be used as biological markers for the diagnosis and differential diagnosis of CHF, and provides a new way for the treatment of CHF. (2)Irisin was positively associated with LVEF, can reflect the heart function condition.