不同病因房颤患者血浆脂联素与B型利钠肽前体及心功能的关系

摘要

目的 探讨不同病因房颤患者血浆脂联素(APN)水平及其与B型利钠肽前体(NT-proBNP)、左室射血分数(LVEF)的关系.方法 将74例房颤患者根据病因分为肺心病合并房颤组(CPD组)25例、冠心病合并房颤组(CHD组)23例、高血压合并房颤组(EH组)26例.检测各组血浆APN、NT-proBNP水平,经胸彩色心脏超声多普勒检测LVEF.结果 CPD组APN较CHD组和EH组明显升高(P均＜0.05),CHD组与EH组比较无统计学差异；三组NT-proBNP及LVEF比较均无统计学差异.相关分析表明,血浆APN与NT-proBNP呈正相关(r=0.21,P＜0.05),与LVEF呈负相关(r=-0.22,P＜0.05),NT-proBNP与LVEF呈负相关(r=-0.34,P＜0.05).结论 房颤合并肺心病患者的血浆APN水平明显升高,提示血浆APN可能与患者发生心力衰竭的基础病因有关,也可能与肺组织纤维化有关.%Objective To investigate the correlations of plasma adiponectin( APN) and NT-proBNP and left ventricular ejection fraction (LVEF) in atrial fibrillation patients with different etiology. Methods Totally 74 patients with atrial fibrillation were divided into 3 groups according to etiology: chronic pulmonary heart disease group ( CPD) (25 cases) , coronary heart disease group ( CHD) (23 cases), essential hypertension group ( EH) (26 cases). The levels of APN, NT-proBNP and LVEF were measured in all patients. Results Compared with CHD group and EH group, the levels of plasma APN were increased significantly in CPD group (all P < 0.05) , there was no significant difference in CHD group and EH group. NT-proBNP and LVEF were no significant difference in 3 groups. The correlation analysis showed that the plasma APN was positively correlated with NT-proBNP (r = 0.21, P < 0.05) , and negatively correlated with LVEF ( r = - 0.22, P <0.05 ) , NT-proBNP were negatively correlated with LVEF( r = -0. 34, P <0.05). Conclusions The levels of plasma APN were significantly elevated in atrial fibrillation patients with chronic pulmonary heart disease. These data suggest that plasma APN may be associated with the underlying etiology on the presence of chronic heart failure, and also pulmonary fibrosis.