充血性心力衰竭患者肿瘤坏死因子-α和可溶性肿瘤坏死因子受体Ⅱ变化及其意义  

The significance and changes of serum tumor necrosis factor-α and soluble tumor necrosis factor receptor II in the patients with congestive heart failure

作　　者：袁国会[1] 王丕荣[2] 桂乐[1] 任法鑫[1] 杜戎[1] 杨钧国[1] 

机构地区：[1]华中科技大学同济医学院协和医院心内科,武汉430022 [2]遵义医学院心内科

出　　处：《中国综合临床》2004年第6期481-483,共3页Clinical Medicine of China

摘　　要：目的　探讨充血性心力衰竭 (CHF)时肿瘤坏死因子 α(TNF α)和可溶性肿瘤坏死因子受体Ⅱ(sTNFRⅡ )的变化及其与CHF的关系。方法　CHF患者 4 5例和年龄匹配的正常对照组 17例 ,根据NY HA分级 ,将CHF患者分成Ⅱ、Ⅲ、Ⅳ级 3组 ;根据体重分成恶病质组及非恶病质组。用酶联免疫法测定sTNFRⅡ ,用放射免疫法测定TNF α。结果　CHF患者血清TNF α和sTNFRⅡ较对照组明显升高 ,TNF α在Ⅲ、Ⅳ级时显著升高 ,sTNFRⅡ在心功能Ⅱ、Ⅲ、Ⅳ级时均显著升高。不同病因的CHF之间TNF α和sTNFRⅡ无显著差异 ,恶病质组及非恶病质组之间无明显变化。血清TNF α与sTNFRⅡ呈正相关 (r =0 .5 14 1,P <0 .0 1)。结论　血清TNF α和sTNFRⅡ水平与CHF的严重程度密切相关 ,可作为判断CHF严重程度及预后的指标。Objective To study the changes of serum tumor necrosis factor-α(TNF-α) and soluble tumor necrosis factor receptor II(sTNFR II) in the patients with congestive heart failure(CHF) and their relation with CHF.Methods sTNFRII was measured by enzyme-linked immunoabsordent assay and TNF-α was detected by radioimmunoassay in 45 cases of CHF who were divided into Ⅱ,Ⅲ and Ⅳ grade groups according to NYHA classification,and divided into cachectic and noncachectic groups on the basis of body weight,and in 17 age-matched controls.Results The level of sTNFRII and TNF-α in CHF patients were significantly elevated as compared with controls.TNF-α level was significantly elevated in patients with Ⅲ and Ⅳ grade and sTNFRII level was significantly increased in patients with cardiac Ⅱ,Ⅲ and Ⅳ grades.There was no significant difference among CHF patients with various etiologies and between cachectic and noncachectic groups.The level of TNF-α was positively correlated with sTNFRII(r=0.514,P<0.01).Conclusioin The levels of serum TNF-α and sTNFRII are closely related with severity of CHF,which can serve as the markers to judge the severity and the prognosis of CHF.

关 键 词：心力衰竭 充血性 肿瘤坏死因子-Α 可溶性肿瘤坏死因子受体 

分 类 号：R541.61[医药卫生—心血管疾病]