慢性心力衰竭患者血浆H2松弛素的表达

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摘要目的：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。

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	朱艳艳1
	潘嘉林2
	陈灵芝3
	周希1
	郑高暑1
	林杰1
	黄伟剑1
	张怀勤1
	周浩1

关键词 ： H2松弛素, 慢性心力衰竭, 纤维化, 严重程度, 预后

Abstract：Objective: To explore the expression of endogenous H2 relaxin hormone in chronic heart failure patients, and the relations with NYHA classification, 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 Affiliated Hospital of Wenzhou Medical University, 109 cases for chronic heart failure group and 31 cases for control group. In the early morning of the first day after admission, patients in each group were exsanguinated in supine, resting status for some venous blood to detect, LDL-cholesterol, hemoglobin, 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 significantly higher than that of control group [0.390 (0.355-0.425)] pg/mL. The difference was statistically significant (P<0.05). ②The tendency as classification 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 significant (P<0.05). ③Plasma level of H2RLX and type I collagen showed significant correlation, there was statistically significant (r=0.889, P<0.001). ④H2RLX levels in chronic heart failure patients could predict the cardiovascular event in one hundred and eighty days. Conclusion: The H2RLX levels elevate in patients with chronic heart failure, which may involve in ventricular fibrosis; H2RLX may help to make preliminary estimation of the severity of chronic heart failure and H2RLX plasma levels may predict the prognosis of cardiovascular events.

Key words： H2 relaxin chronic heart failure fibrosis severity prognosis

收稿日期: 2014-01-08

基金资助:浙江省自然科学基金资助项目（LY12H02004）。

通讯作者: 周浩，副主任医师，Email：wyzh66@126.com。

作者简介: 朱艳艳（1987-），女，浙江温州人，住院医师，硕士。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2015/V45/I1/22

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