老年慢性左心衰患者多种生物标记物变化及临床意义  

Clinical significance and change of multiple biomarkers in elderly with chronic left heart failure

作　　者：李侠[1] 胡有东[1] 郭燕[1] 张枫林[1] 周华兰[1] 杨海晨[1] 

机构地区：[1]徐州医学院附属淮安医院,江苏淮安223002

出　　处：《山东医药》2011年第5期4-6,共3页Shandong Medical Journal

基　　金：江苏省高校自然科学研究计划项目(KJD310234);淮安市科技局科技项目(HAS04020)

摘　　要：目的探讨老年慢性左心衰(LHF)患者多种生物标记物变化的临床意义。方法选择86例心功能Ⅰ～Ⅳ级的老年慢性LHF患者,检测其CD34+细胞、TNF-α、可溶性肿瘤坏死因子受体-1(sTNFR-1)、sTNFR-2、血管内皮生长因子(VEGF)、Toll样受体(TLR2、TLR4)及左室射血分数(LVEF),并与正常对照者比较。结果与正常人比较,LHF患者早期CD34+细胞升高、随着心功能级别增加而明显下降,TNF-α、sTNFR-1、sTNFR-2、VEGF、TLR2和TLR4明显升高(P<0.05或<0.01);患者的心功能及LVEF均与TNF-α、sTNFR-1、sTNFR-2、VEGF、TLR2、TLR4呈负相关(P均<0.01)。结论老年慢性LHF患者TNF-α、sTNFR-1、sTNFR-2、VEGF、TLR2和TLR4明显升高,上述指标变化可能与LHF的发生、发展及其严重程度有关。Objective To investigate the clinical significance of multiple biomarkers in elderly with chronic left heart failure（LHF）.Methods A total of 86 elderly patients with chronic left ventricular failure whose heart function were from NYHA Ⅰto NYHA Ⅳ.CD34＋ cells,tumor necrosis factor-α（TNF-α）,sTNFR-1,sTNFR-2,VEGF,Toll-like receptors（TLR2、TLR4） and LVEF were measured,and compared to those of normal controls.Results Compared to normal subjects,the levels of CD34＋ cells on elderly patients with LHF were elevated in the early stage and decreased with advanced heart function stage.TNF-α,sTNFR-1,sTNFR-2,VEGF,TLR2 and TLR4 were increased（P0.05 or 0.01）.Cardiac function and LVEF of patients were inversely associated with TNF-α,sTNFR-1,sTNFR-2,VEGF,TLR2,TLR4（all P0.01）.Conclusions The levels of TNF-α,sTNFR-1,sTNFR-2,VEGF,TLR2 and TLR4 were significantly higher in elderly patients with chronic LHF,and the changes of aboved factors may be associated with generation,progress and the graveness degree of LHF.

关 键 词：左心衰竭 慢性 肿瘤坏死因子 血管内皮生长因子 TOLL样受体 

分 类 号：R541.6[医药卫生—心血管疾病]