2026 年第 6 期 第 21 卷

脂肪因子颗粒蛋白前体和抵抗素与老年慢性心力衰竭合并衰弱患者炎症标志物和营养指标的相关性及其诊断价值研究

Correlation of adipokine progranulin and resistin with inflammatory markers and nutritional indicators in elderly patients with chronic heart failure complicated with frailty and their diagnostic value

作者：高丽娜1吴迪2

英文作者：Gao Lina1 Wu Di2

单位：1黑龙江省第二医院心内二科，哈尔滨150010；2黑龙江省第二医院心内一科，哈尔滨150010

英文单位：1The Second Department of Cardiology The Second Hospital of Heilongjiang Province Harbin 150010 China; 2The First Department of Cardiology The Second Hospital of Heilongjiang Province Harbin 150010 China

关键词：慢性心力衰竭；颗粒蛋白前体；抵抗素；炎症；营养；衰弱

英文关键词：Chronicheartfailure;Progranulin;Resistin;Inflammation;Nutrition;Frailty

• 摘要：

• 目的 探讨血清脂肪因子颗粒蛋白前体（PGRN）、抵抗素与老年慢性心力衰竭（ECHF）合并衰弱患者炎症标志物和营养指标的相关性及其诊断价值。方法 选取2022年3月至2025年6月黑龙江省第二医院收治的ECHF患者203例（ECHF组），另选取同期年龄、性别匹配的社区人群184例作为对照组检测PGRN和抵抗素水平，再根据是否合并衰弱将ECHF患者分为衰弱组和非衰弱组。检测ECHF患者血清PGRN、抵抗素、炎症标志物［白细胞介素1β（IL-1β）、IL-6、肿瘤坏死因子α（TNF-α）］水平和计算营养指标［营养风险筛查2002（NRS 2002）评分］，采用Pearson相关分析ECHF合并衰弱患者血清PGRN、抵抗素与炎症标志物和营养指标的相关性，分析ECHF合并衰弱的影响因素及血清PGRN、抵抗素水平的诊断价值。结果 与对照组比较，ECHF组血清PGRN、抵抗素水平升高［（66±17）μg/L比（44±9）μg/L、（8.1±2.7）μg/L比（4.2±1.4）μg/L］（均P＜0.001）。ECHF合并衰弱患者血清PGRN、抵抗素与IL-1β、IL-6、TNF-α、NRS 2002评分呈正相关（均P＜0.001）。年龄增加（比值比＝1.128，P＝0.001）、心力衰竭病程延长（比值比＝1.302，P＝0.009）、纽约心脏病协会心功能分级Ⅳ级（比值比＝4.104，P＝0.037）、PGRN升高（比值比＝1.111，P＜0.001）、抵抗素升高（比值比＝1.775，P＜0.001）为ECHF患者合并衰弱的独立危险因素。血清PGRN、抵抗素单独及二者联合诊断ECHF患者合并衰弱的曲线下面积分别为0.794、0.807和0.898，二者联合诊断的曲线下面积最优（均P＜0.05）。结论 ECHF合并衰弱患者血清PGRN、抵抗素水平升高与炎症反应增强、营养不良有关，血清PGRN、抵抗素水平联合对ECHF合并衰弱的诊断价值较高。

• Objective To explore the correlation of serum adipokine progranulin (PGRN) and resistin with inflammatory markers and nutritional indicators in elderly chronic heart failure (ECHF) patients complicated with frailty, and to analyze their diagnostic value. Methods A total of 203 ECHF patients admitted to The Second Hospital of Heilongjiang Province from March 2022 to June 2025 were enrolled as the ECHF group, and 184 age- and gender-matched community residents were selected as the control group. Levels of PGRN and resistin were detected. ECHF patients were further divided into frailty subgroup and non-frailty subgroup according to the complication of frailty. Serum levels of PGRN, resistin and inflammatory markers including interleukin-1β (IL-1β), IL-6 and tumor necrosis factor-α (TNF-α) were detected, and nutritional risk screening 2002 (NRS 2002) score in the ECHF patients was calculated. Pearson correlation analysis was used to analyze the correlations of serum PGRN and resistin with inflammatory markers and nutritional indicators in ECHF patients complicated with frailty. The influencing factors of frailty in ECHF patients and the diagnostic value of serum PGRN and resistin were analyzed. Results Compared with the control group, serum levels of PGRN and resistin in the ECHF group were increased ［(66±17)μg/L vs (44±9)μg/L, (8.1±2.7)μg/L vs (4.2±1.4)μg/L］(all P＜0.001). Serum PGRN and resistin were positively correlated with IL-1β, IL-6, TNF-α and NRS 2002 score in ECHF patients complicated with frailty (all P＜0.001). Advanced age (odds ratio=1.128, P=0.001), prolonged course of heart failure (odds ratio=1.302, P=0.009), New York Heart Association functional class Ⅳ (odds ratio=4.104, P=0.037), elevated PGRN (odds ratio=1.111, P＜0.001) and elevated resistin (odds ratio=1.775, P＜0.001) were independent risk factors for frailty in ECHF patients. The area under the curve of PGRN alone, resistin alone, and their combination for diagnosing frailty in ECHF patients was 0.794, 0.807 and 0.898 respectively, and the combined diagnosis showed the optimal efficacy (all P＜0.05). Conclusion The elevated serum levels of PGRN and resistin in ECHF patients complicated with frailty are related to enhanced inflammatory response and malnutrition. The combined detection of serum PGRN and resistin has high diagnostic value for frailty complicated with ECHF.