目的：评价慢性心力衰竭(CHF)患者外周血中的人血管内皮抑制素（vasostatin-II, VS-II）的水平及临床意义。 

方法：采用酶联免疫吸附法(ELISA)对450例经心超确诊为CHF的患者和225例心超正常者(对照组)外周血进行VS-II含量的检测。CHF组根据纽约心功能分级（NYHA）分三个亚组。所有患者电话或心衰专病及专家门诊随访2年。 

结果：CHF患者血清VS-II水平明显低于对照组（P<0.001），与左室射血分数（LVEF）成正相关（Pearson's r =0.173, P<0.001），且与N-末端脑钠肽前体（NT-proBNP）成负相关（Pearson’s r = -0.193, P=0.001）；多元线性逐步回归分析显示影响VS-II水平的独立因素为LVEF、TNF-α；随访的CHF患者生存分析显示血清VS-II水平越低，早期死亡率和总死亡率越高，预后越差。 

结论：CHF患者血清VS-II明显降低；心功能越差，血清VS-II水平越低，预后越差，血清VS-II水平与NT-proBNP水平呈负相关，临床上对CHF患者预后的评估和诊疗有一定的指导意义。

【关键词】慢性心力衰竭；血管抑制因子；预后；N-末端脑钠肽前体

Expression of vasostatin-II in the serum of patients with chronic heart failure

SU Qian, LI Jinping, WU Qiong, Lu lin, ZHANG Fengru, Department of Cardiology , Ruijin Hospital , Shanghai Jiao Tong University School of Medicine , Shanghai 200025 , China

Corresponding author: ZHANG Fengru. E-mail: zhangfengru_0503@163. com

【Abstract】

Objective: To investigate the serum levels of vasostatin-II(VS-II) and it's clinical significance in patients with chronic heart failure (CHF).  

Methods: The levels of serum VS-II were detected using enzyme-linked immunosorbent assay (ELISA) in 450 patients with chronic heart failure and 225 control cases. All patients with CHF were further devided into three subgroups according to NYHA. All cases had been followed up for 2 years by telephone or outpatient service. 

Results: Serum VS-II levels were extraordinarily lower in CHF group than in control group (P<0.001), and were positively correlated with LVEF (Pearson's r =0.173, P<0.001), while were negatively correlated with NT-proBNP (another biomarker of CHF) (Pearson’s r = -0.193, P=0.001); Linear stepwise regression showed that serum VS-II levels were influenced by LVEF、TNF-α; Survival analysis showed that the lower serum VS-II levels were, the early mortality and total mortality were higher, which suggested the more poor prognosis of CHF patients.  Conclusion: The serum levels of vasostatin-II decreased significantly in patients with CHF. More over, VS-II levels were positively correlated with the cardiac function of CHF patients. It indicates that decreased circulating VS-II levels have important prognostic, diagnostic and  therapeutic significance in patients with CHF. 

【Key words】chronic heart failure ; vasostatin-II ; prognosis ; NT-proBNP