CHF患者血红蛋白水平差异与血清BNP、TNF-α、sICAM-1的关系以及对MWS和LVMI的影响  

Relationship between hemoglobin(Hb) concentration and TNF-α, sICAM-1, ventricular remodeling, and cardiac function in patients with congestive heart failure

作　　者：郗爱旗[1] 褚以德[1] 李国峰[1] 赵文蕊[1] 钟欣[1] 廖宝霞[1] 李英兰[1] 尚玲[1] 

机构地区：[1]青海省人民医院老年医学研究所,青海西宁810007

出　　处：《中国现代医学杂志》2007年第23期2875-2878,共4页China Journal of Modern Medicine

基　　金：青海省科技厅自然科学基金(No:2006-N-149)

摘　　要：目的研究慢性心力衰竭(CHF)患者血红蛋白水平与血浆B型钠尿肽(BNP)、血清肿瘤坏死因子-α(TNF-α)、可溶性细胞间黏附分子-1(sICAM-1)的关系及对左心室质量指数(LVMI)和平均室壁应力(MWS)、心功能的影响。方法对入选的121例CHF患者测定了血红蛋白浓度、血浆BNP、血清TNF-α和sICAM-1水平,超声心动图测量左室射血分数(LVEF),评价心功能;计算LVMI和MWS;按血红蛋白水平分为CHF贫血组和非贫血组,同时选择27例正常人作为对照组。结果CHF患者Hb水平和LVEF低于正常对照组,而血浆BNP、血清TNF-α和sICAM-1水平以及MWS和LVMI高于对照组(P<0.01);随着心功能恶化,Hb水平和LVEF则逐渐降低,而血浆BNP、血清TNF-α和sICAM-1水平以及MWS和LVMI逐渐升高;CHF贫血组患者血浆BNP、血清TNF-α和sICAM-1水平以及MWS和LVMI均升高,明显高于非贫血组患者P<0.01);随着贫血程度的加重,CHF患者血浆BNP、血清TNF-α和sICAM-1水平以及MWS和LVMI进一步升高(P<0.01);CHF患者MWS和LVMI与Hb水平、血浆BNP、TNF-α和sICAM-1水平均呈正相关(P<0.01)。结论CHF患者Hb水平的降低和TNF-α和sICAM-1水平的升高参与了心功能不全心室重构发生发展的病理生理过程,而CHF患者贫血的出现使心功能不全心室重构程度加重化。[Objective] To study the relationships between hemoglobin（Hb） concentration and turner necrosis faetor-α（TNF-α）, soluble intercellular adhesion molecule-1 （sICAM-1）, B-type natriuretic peptid （BNP）, and effect on left ventricular mass index（LVMI）, mean wall stress（MWS） and cardiac function in patients with congestive heart failure （CHF）. [Methods] Hb concentration, serum TNF-α, sICAM-1 and BNP in 121 CHF patients were measured. Left ventricular ejection fraction（LVEF） by echocardiography, and LVMI and MWS were calculated. [Results] The levels of TNF-α, sICAM-1, BNP and LVMI, MWS in the anemic patients group of CHF patients were higher than those in the non-anemic group subjects. With the increase of anemia severity, the levels of TNF-α, sICAM-1, BNP and LVMI, MWS significantly increased;there was a positive correlation between LVMI, MWS and the levels of TNF-α, sICAM-1, BNP （P 〈0.01）, and a negative correlation between LVMI, MWS and Hb concentration. [Condusion] Increasing in the levels of TNF-α and sICAM-1 play roles in pathophysiological and pathogenetic mechanism of ventricular remodeling and anemia in CHF, and correlated with the severity degree of ventricular remodeling and anemia in CHF.

关 键 词：慢性心力衰竭 肿瘤坏死因子-α 可溶性细胞间黏附分子-1 B型钠尿肽 左心室质量指数 室壁应力 心室重构 

分 类 号：R541.6[医药卫生—心血管疾病]