【摘要】 目的 探究慢性心力衰竭患者脂代谢指标、丝氨酸蛋白酶抑制剂（Vaspin）、摄食抑制因子1、脂联素与C反应蛋白（CRP）、白细胞介素-6(IL-6)水平及左心室重构关系。方法 研究对象选取河北北方学院附属第一医院2023年12月至2024年6月收治的慢性心力衰竭患者合计246例，根据患者是否合并左心室重构将所有患者分为对照组（121例）及重构组（125例）。比较两组患者左心室重构相关参数及脂代谢指标、Vaspin、摄食抑制因子1、脂联素、CRP、IL-6水平。使用Logistic多因素回归分系患者左心室重构独立危险因素，使用Pearson相关性模型分析左心室重构相关参数与脂代谢指标、Vaspin、摄食抑制因子1、脂联素、CRP、IL-6水平相关性。结果 重构组左心室舒张末期尺寸（LVEDD）、左心室收缩末内径（LVESd）、左心室后壁厚度（LVPWT）、室间隔厚度（IVSTd）、左心室质量指数（LVMI）高于对照组[（76.84±10.54）mm比（67.08±9.47）mm、（78.41±11.38）mm比（65.29±10.44）mm、（17.43±4.02）mm比（12.19±3.45）mm、（17.64±4.11）mm比（12.28±3.51）mm、（149.83±23.19）g/m2比（139.74±21.46）g/m2）]，左心室射血分数（LVEF）低于对照组[（35.44±7.69）%比（40.18±7.81）%,P<0.05]；重构组总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）高于对照组[（5.56±1.11）mmol/L比（4.71±1.03）mmol/L、（1.75±0.05）mmol/L比（1.64±0.04）mmol/L、（1.71±0.16）mmol/L比（1.48±0.14）mmol/L、（2.86±0.59）mmol/L比（2.55±0.54）mmol/L,P<0.05]；重构组Vaspin、摄食抑制因子1、脂联素低于对照组[（0.49±0.05）mg/ml比（0.73±0.07）mg/ml、（117.04±21.49）pg/ml比（131.57±24.61）pg/ml、（8.36±1.07）mg/比（9.03±1.24）mg/L,P<0.05]；重构组CRP、IL-6高于对照组（P<0.05）;Logistic多因素回归分析结果显示，TC、TG、LDL-C、HDL-C、Vaspin、摄食抑制因子1、脂联素、CRP、IL-6水平均是引起慢性心力衰竭患者左心室重构独立危险因素（P<0.05）;Pearson相关性分析结果显示，LVEDD、LVESd、LVPWTs、IVSTd、LVMI水平与TC、TG、LDL-C、HDL-C、CRP、IL-6水平呈正相关，与Vaspin、摄食抑制因子1、脂联素水平呈负相关；LVEF水平与TC、TG、LDL-C、HDL-C、CRP、IL-6水平呈负相关，与Vaspin、摄食抑制因子1、脂联素水平呈正相关（P<0.05）。结论 慢性心力衰竭合并左心室重构患者表现出脂代谢指标、CRP、IL-6水平升高，Vaspin、摄食抑制因子1、脂联素降低，且均为患者左心室重构独立危险因素，慢性心力衰竭患者脂代谢指标、Vaspin、摄食抑制因子1、脂联素与CRP、IL-6水平与左心室重构存在相关性。更多还原

【Abstract】 Objective To explore the relationship between lipid metabolism index, Vaspin, food intake inhibitor 1, adiponectin, C-reactive protein(CRP), interleukin-6(IL-6) and left ventricular remodeling in patients with chronic heart failure. Methods A total of 246 patients with chronic heart failure admitted to the First Affiliated Hospital of Hebei North University from December 2023 to June 2024 were selected. All patients were divided into control group(121 cases) and remodeling group(125 cases) according to whether they had left ventricular remodeling. The left ventricular remodeling related parameters, lipid metabolism indexes, Vaspin, food intake inhibitor-1, adiponectin, CRP, and IL-6 levels were compared between the two groups. Multivariate Logistic regression was used to identify the independent risk factors of left ventricular remodeling. Pearson correlation model was used to analyze the correlation between left ventricular remodeling related parameters and lipid metabolism indicators, Vaspin, food intake inhibitory factor 1, adiponectin, CRP and IL-6 levels. Results Left ventricular end-diastolic dimension(LVEDD), left ventricular end-systolic diameter(LVESd), left ventricular posterior wall thickness(LVPWT), interventricular septal thickness(IVSTd) and left ventricular mass index(LVMI) were significantly higher in the remodeling group than in the control group [(76.84±10.54) mm vs.(67.08±9.47) mm、(78.41±11.38) mm vs.(65.29±10.44) mm、(17.43±4.02) mm vs.(12.19±3.45) mm、(17.64±4.11) mm vs.(12.28±3.51) mm、(149.83±23.19) g/m2vs.(139.74±21.46) g/m2)], and left ventricular ejection fraction(LVEF)was significantly lower than that in the control group [(35.44 ± 7.69)% vs.(40.18 ± 7.81)%, P<0.05]. Total cholesterol(TC), triglyceride(TG), low density lipoprotein cholesterol(LDL-C) and high density lipoprotein cholesterol(HDL-C) in remodeling group were higher than those in control group [(5.56±1.11) mmol/L vs.(4.71±1.03) mmol/L、(1.75±0.05) mmol/L vs.(1.64±0.04) mmol/L、(1.71±0.16) mmol/L vs.(1.48±0.14) mmol/L、(2.86±0.59) mmol/L vs.(2.55±0.54) mmol/L, P<0.05]. The levels of Vaspin, feeding inhibitory factor 1 and adiponectin in the remodeling group were lower than those in the control group [(0.49±0.05) mg/ml vs.(0.73±0.07) mg/ml、(117.04±21.49) pg/ml vs.(131.57±24.61) pg/ml、(8.36±1.07) mg/L vs.(9.03±1.24) mg/L, P<0.05]. The levels of CRP and IL-6 in the remodeling group were higher than those in the control group(P<0.05). Logistic multivariate regression analysis showed that the levels of TC, TG, LDL-C, HDL-C, Vaspin, food intake inhibitor-1, adiponectin,CRP and IL-6 were independent risk factors for left ventricular remodeling in patients with chronic heart failure(P<0.05). Pearson correlation analysis showed that the levels of LVEDD, LVESd, LVPWTs, IVSTd and LVMI were positively correlated with the levels of TC, TG, LDL-C, HDL-C, CRP and IL-6, and negatively correlated with the levels of Vaspin, feeding inhibitory factor 1 and adiponectin. The level of LVEF was negatively correlated with the levels of TC, TG, LDL-C, HDL-C, CRP and IL-6, and positively correlated with the levels of Vaspin,feeding inhibitory factor 1 and adiponectin(P<0.05). Conclusions Patients with chronic heart failure and left ventricular remodeling show increased levels of lipid metabolism indexes, CRP and IL-6, and decreased levels of Vaspin, feeding inhibitory factor 1 and adiponectin, which are independent risk factors for left ventricular remodeling. The levels of lipid metabolism indexes, Vaspin, feeding inhibitory factor 1, adiponectin, CRP and IL-6are correlated with left ventricular remodeling in patients with chronic heart failure.更多还原