血清补体C1q肿瘤坏死因子相关蛋白3水平与慢性心力衰竭的相关性分析
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摘要
目的探讨血清补体C1q肿瘤坏死因子相关蛋白3(CTRP3)浓度水平与瓣膜性心脏病(VHD)和扩张型心肌病(DCM)所合并的心力衰竭的相关性。方法选取的病例是由2016年11月至2017年1月本院收治的59例VHD和DCM导致的心力衰竭患者,患者心功能均为美国纽约心脏病协会(NYHA)分级Ⅱ～Ⅳ级,另选取50例同期来院的健康体检者作为健康对照组。收集两组患者一般临床资料,采用酶联免疫吸附法测定入院时采集的患者血清中CTRP3的浓度,进行统计学分析比较两组CTRP3的水平,并比较不同NYHA分级、不同病因所导致的心力衰竭患者的血清CTRP3水平,分析血清CTRP3水平与血清N末端B型利钠肽原(NT-proBNP)浓度和左室射血分数(LVEF)值的相关性。结果病例组患者血清CTRP3浓度较对照组显著升高,且NYHA心功能分级等级越高,血清CTRP3浓度越高,差异有统计学意义(P <0.05)。心衰患者血清CTRP3水平与血清NT-proBNP水平呈线性正相关,与LVEF值呈线性负相关,有统计学意义(P <0. 05)。DCM患者血清CTRP3水平较VHD患者高,差异有统计学意义(P <0.05)。结论慢性心力衰竭患者血清CTRP3水平显著升高,且随心衰程度加重而升高,不同病因导致的心衰血清CTRP3升高程度也存在差异。
Objective To investigate the relationship between serum CTRP3 level and heart failure in patients with valvular heart disease( VHD) or dilated cardiomyopathy( DCM). Methods A total of 59 patients with heart failure caused by VHD or DCM admitted to our hospital from November 2016 to January 2017 were selected. The heart function of the patients was New York Heart Association( NYHA) class 2-4. Another 50 healthy people were selected as the control group. Clinical data of the two groups were collected.Concentration of CTRP3 in the serum was determined by enzyme-linked immunosorbent assay( ELISA). Patients with heart failure under different NYHA classes and from different causes were compared respectively. Serum CTRP3 levels were analyzed for correlation with serum NT-proBNP concentrations and left ventricular ejection fraction( LVEF) values. Results Serum CTRP3 levels in patients were significantly higher than those in the control group.The patients under higher NYHA classes had higher serum CTRP3 levels( P <0.05). There was a linear positive correlation between serum CTRP3 level and serum NT-proBNP level in patients with heart failure,but a linear negative correlation with LVEF( P <0.05). Serum CTRP3 levels in DCM patients were significantly higher than those in VHD patients( P <0.05). Serum CTRP3 levels in DCM patients were higher than those in VHD patients,and the difference was statistically significant( P <0.05). Conclusion Serum CTRP3 levels in patients with chronic heart failure significantly increased with the severity of heart failure. There were also differences in the degree of CTRP3 elevation caused by heart failure with different causes.
Objective To investigate the relationship between serum CTRP3 level and heart failure in patients with valvular heart disease( VHD) or dilated cardiomyopathy( DCM). Methods A total of 59 patients with heart failure caused by VHD or DCM admitted to our hospital from November 2016 to January 2017 were selected. The heart function of the patients was New York Heart Association( NYHA) class 2-4. Another 50 healthy people were selected as the control group. Clinical data of the two groups were collected.Concentration of CTRP3 in the serum was determined by enzyme-linked immunosorbent assay( ELISA). Patients with heart failure under different NYHA classes and from different causes were compared respectively. Serum CTRP3 levels were analyzed for correlation with serum NT-proBNP concentrations and left ventricular ejection fraction( LVEF) values. Results Serum CTRP3 levels in patients were significantly higher than those in the control group.The patients under higher NYHA classes had higher serum CTRP3 levels( P <0.05). There was a linear positive correlation between serum CTRP3 level and serum NT-proBNP level in patients with heart failure,but a linear negative correlation with LVEF( P <0.05). Serum CTRP3 levels in DCM patients were significantly higher than those in VHD patients( P <0.05). Serum CTRP3 levels in DCM patients were higher than those in VHD patients,and the difference was statistically significant( P <0.05). Conclusion Serum CTRP3 levels in patients with chronic heart failure significantly increased with the severity of heart failure. There were also differences in the degree of CTRP3 elevation caused by heart failure with different causes.
引文
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[16] Tengiz I,Turk UO,Alioglu E,et al. The relationship between adiponectin,NT-pro-BNP and left ventricular ejection fraction in non-cachectic patients with systolic heart failure:an observational study[J]. Anadolu Kardiyol Derg,2013,13(3):221-226.
[17]丁海峰,孙莉,田淑婷,等.相同心功能分级不同病因所致心功能不全患者BNP与射血分数的关系[J].临床和实验医学杂志,2015,14(12):1001-1004.
[18] Palazzuoli A,Gallotta M,Quatrini I,et al. Natriuretic peptides(BNP and NT-proBNP):measurement and relevance in heart failure[J]. Vasc Health Risk Manage,2010,6:411-418.
[19]马瑞,桂静,彭松,等.外周血清糖类抗原125水平与不同病因心力衰竭B型钠尿肽水平及心功能相关性研究[J].实用心脑肺血管病杂志,2013,21(9):22-23.
[2]韩额尔德木图,马月宏,王海燕,等.慢性心衰的病理生理及发病机制研究进展[J].中西医结合心脑血管病杂志,2016,14(12):1349-1352.
[3] Yi W,Sun Y,Yuan Y,et al. C1q/tumor necrosis factor-related protein-3,a newly identified adipokine,is a novel antiapoptotic,proangiogenic,and cardioprotective molecule in the ischemic mouse heart[J]. Circulation,2012,125(25):3159-3169.
[4] Yang Y,Li Y,Ma Z,et al. A brief glimpse at CTRP3 and CTRP9 in lipid metabolism and cardiovascular protection[J].Prog Lipid Res,2016,64:170-177.
[5] Wu D,Lei H,Wang JY,et al. CTRP3 attenuates post-infarct cardiac fibrosis by targeting smad3 activation and inhibiting myofibroblast differentiation[J] J Mol Med(Berl),2015,93(12):1311-1325.
[6] Genet M,Lee LC,Baillargeon B,et al. Modeling pathologies of diastolic and systolic heart failure[J]. Ann Biomed Eng,2016,44(1):112-127.
[7] Katz AM,Rolett EL. Heart failure:when form fails to follow function[J]. Eur Heart J,2016,37(5):449-454.
[8] Gaggin HK,Januzzi JL Jr. Biomarkers and diagnostics in heart failure[J],Biochim Biophys Acta,2013,1832(12):2442-2450.
[9] Santaguida PL,Don-Wauchope AC,Oremus M,et al. BNP and NT-proBNP as prognostic markers in persons with acute decompensated heart failure:a systematic review[J]. Heart Fail Rev,2014,19(4):453-470.
[10] Frangogiannis NG. The inflammatory response in myocardial injury,repair,and remodeling[J]. Nat Rev Cardiol,2014,11(5):255-265.
[11] Tham YK,Bernardo BC,Ooi JY,et al. Pathophysiology of cardiac hypertrophy and heart failure:signaling pathways and novel therapeutic targets[J]. Arch Toxicol,2015,89(9):1401-1438.
[12] Li Y,Wright GL,Peterson JM. C1q/TNF-Related protein 3(CTRP3)function and regulation[J]. Compr Physiol,2017,7(3):863-878.
[13] Li X,Jiang L,Yang M,et al. CTRP3 modulates the expression and secretion of adipokines in 3T3-L1 adipocytes[J]. Endocr J,2014,61(12):1153-1162.
[14] Caselli C,D'Amico A,Cabiati M,et al. Back to the heart:the protective role of adiponectin[J]. Pharmacol Res,2014,82:9-20.
[15] Sokhanvar S,Sheykhi M,Mazlomzade S,et al. The relationship between serum adiponectin and prognosis in patients with heart failure[J]. Bratisl Lek Listy,2013,114(8):455-459.
[16] Tengiz I,Turk UO,Alioglu E,et al. The relationship between adiponectin,NT-pro-BNP and left ventricular ejection fraction in non-cachectic patients with systolic heart failure:an observational study[J]. Anadolu Kardiyol Derg,2013,13(3):221-226.
[17]丁海峰,孙莉,田淑婷,等.相同心功能分级不同病因所致心功能不全患者BNP与射血分数的关系[J].临床和实验医学杂志,2015,14(12):1001-1004.
[18] Palazzuoli A,Gallotta M,Quatrini I,et al. Natriuretic peptides(BNP and NT-proBNP):measurement and relevance in heart failure[J]. Vasc Health Risk Manage,2010,6:411-418.
[19]马瑞,桂静,彭松,等.外周血清糖类抗原125水平与不同病因心力衰竭B型钠尿肽水平及心功能相关性研究[J].实用心脑肺血管病杂志,2013,21(9):22-23.