| Background:The morbidity and mortality of Coronary heart disease(CHD)are very high.And ischemic heart failure is also an important factor that leads to the high mortality rate of CHD.Therefore,how to prevent the occurrence or development of CHD and IHF is still a big problem in the medical field.Ghrelin is a multi-functional brain-intestinal peptide,mainly produced by the gastrointestinal tract,and it is also be produced by myocardium.It has many myocardial protective effects,such as anti-atherosclerosis,anti-heart failure etc.Therefore,investigating the variation of the ghrelin level of plasma in the whole course of ischemic myocardium is very important.In addition,ghrelin has a certain therapeutic value,but it has not been applied in clinical practice.So if we can find a method,which can influence the ghrelin level of plasma and can play its positive roles,will provide a new treatment of ischemic heart failure.We have known that ghrelin can regulate the secretion of gastric acid,and PPIs has the same target as ghrelin.And whether we can use the PPIs to regulate the ghrelin level in IHF patients who are on the basis of conventional anti-heart failure treatment is also one of the objectives of this study.Methods:We selected 111 cases in the cardiovascular department of the Second Hospital Of Jilin University from February 2018 to October 2018.There were 50 cases with myocardial infarction(MI)who were not attacked by heart failure(HF)(26 males and24 females,ranging in age from 45 to 80 years old,with an average age of 60.57 years old).Another 50 cases were attacked by ischemic heart failure(IHF)(31 males and 19 females,age range 42~ 85 years old,average age 67.21 years old).There were 11 cases in the normal control group(4 males and 7 females,ranging from 56 to 76 yearsold,with an average age of 61.72 years).This study was divided into three parts.The first part studied the changes of plasma ghrelin level in MI group without heart failure and its correlation with age,Gensini integral,TC,LDL-c,cTnI and Hcy,to discuss the significance of ghrelin in MI without heart failure.The second part studied the changes of plasma ghrelin level in IHF group and its correlation with NT-pro BNP,TB,AST,ALT,Scr,age,TC,LDL-c,ALB and EF,to discuss the significance of ghrelin in the ischemic heart failure.The third part compared the changes of plasma ghrelin level before and after treatment in IHF group,and discussed the relationship between PPIs and plasma ghrelin level in IHF patients..Result:Part I: Plasma ghrelin level in the MI group without heart failure is positively correlated with age and Gensini score,and negatively correlated with TC,LDL-c,cTnI and Hcy,but only Gensini score has significance.Part II: Compared with the normal control group,the level of ghrelin in the ischemic heart failure(IHF)group was significantly higher,P<0.05.Plasma Ghrelin level in IHF was positively correlated with NT-pro BNP,TB,AST,ALT,Scr and age,and negatively correlated with TC,LDL-c,ALB and EF,but only with NT-pro BNP has significance.Part III:Plasma ghrelin level was lower in the conventional treatment group and the PPIs adjuvant treatment group after treatment than before,but there was no statistical difference between the two groups.Conclusions:1)Plasma ghrelin level in patients with myocardial infarction may be related to the severity of coronary,which can be used as an predictor to the coronary heart disease.2)Ghrelin level of patients with ischemic heart failure is increasing as an compensatory,and positively correlated with NT-pro BNP,and ghrelin could be used as an predictor to evaluate the severity of heart failure.3)Plasma ghrelin level can be used as an predictor to evaluate the therapeutic effect of heart failure.4)PPIs has little effect in the treatment of chronic ischemic heart failure patients with plasma ghrelin levels. |
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