Intervention Treatment Of Serum Chemokine In Patients With Chronic Heart Failure And The Change Of Spironolactone

Objective: Heart failure is the final outcome of the vast majority of heartdisease, the pathogenesis of chronic heart failure complicated, has not yet beenable to completely clear, think at present by the neural and humoral regulationmechanism of common compensation caused by. Renin angiotensinaldosterone (RAAS) system activation, increased the retention of water andsodium, mediated myocardial remodeling, because in the occurrence anddevelopment of heart failure plays an important role and has been widelystudied. Chemerin is a newly discovered adipocytokines, widely exists in theliver and adipose tissue. More research about disease chemerin and diabetes,metabolic syndrome, obesity, coronary atherosclerosis and cancer in recentyears, has found that chemokines involved in lipid metabolism, insulinresistance and inflammation mediated. However, more research relationshipwith chronic heart failure in patients with chronic heart failure and the changesin the levels of little reports. Because as a potassium-sparing diureticspironolactone, aldosterone competition and occupy the mineralocorticoidreceptor, produce against the role of aldosterone, thereby inhibiting theactivation of the RAAS system, is widely used in the treatment of heart failure.This study attempts to compare the heart failure patients and non heart failuregroup, not concentric chemerin levels in patients with heart failure and toexplore the function of the degree, after chemerin changes after treatment withspironolactone.Method:60patients with chronic heart failure in2012January to2012October in selected cardiovascular department of internal medicine, HebeiMedical University second hospital patients,30cases of healthy people.Inclusion criteria: heart failure diagnosis with "ESC Guidelines for thediagnosis and treatment of acute and chronic heart failure2008" standard of diagnosis, NYHA cardiac functional grading criteria of heart function â…¡-â…£ in chronic heart failure patients. Heart failure exclusion criteria:(1) heartfailure valvular heart disease;(2) infection;(3) pulmonary heart disease;(4)diabetes, hyperthyroidism and other metabolic diseases;(5) renal insufficiency,liver function damage (6); autoimmune diseases;(7) tumors. All the researchobject of conventional history collection, collection of height, weight, bodymass index (BMI=body weight kg, height^2m), fasting venous blood werecollected at admission, blood routine, blood glucose, liver function, renalfunction, ultrasound heartbeat graph examination. Given the same dose ofaspirin, isosorbide mononitrate preparations, loop diuretics, beta blockers,statins and ACEI class of drugs, on the basis of spironolactone group receivedspironolactone20mg Tid oral, heart failure patients in4weeks for1courses.All patients with heart failure on admission day, the28day gatheringpreprandial blood3ml, ELISA, enzyme-linked immunosorbent assay, serumChemerin, hs-CRP levels in serum by immune turbidimetry ratiomeasurement.Result: Heart failure group and control group in gender, age, BMI,cholesterol, triglyceride, fasting blood glucose, no significant statisticaldifference (P>0.05), but the patients with left ventricular failure index wassignificantly higher than that of control group (P=0.005)(Table1). There wasa significant difference of serum chemerin in patients with heart failure andnormal control group and high sensitivity C reactive protein (P=0.01)(Table2). Patients with mild to moderate heart failure (NYHAâ…¡, â…¢) with severeheart failure patients (NYHA IV), there was a significant difference in serumChemerin level (P=0.01), but no significant differences of serum highsensitivity C reactive protein (P=0.67)(Table3). Heart failure patients aftertreatment, serum Chemerin and high sensitive C reactive protein weresignificantly decreased (P=0.01)(Table4). Patients with mild to moderateheart failure (NYHAâ…¡, â…¢), the intervention group received spironolactonetherapy and non intervention group not receiving spironolactone therapycompared, there was a significant difference of serum Chemerin and high sensitive C reactive protein (P=0.01)(Table5).Conclusion: Can be drawn through this research, Chemerin, in heartfailure in patients with hs-CRP have higher levels of expression, and theChemerin level was positively correlated with cardiac function class. Aftercorrecting heart failure, Chemerin, hs-CRP were decreased obviously. Inpatients with mild, moderate heart failure, patients after spironolactonetreatment, Chemerin, hs-CRP level has obvious improvement.