冠心病心肌梗死后慢性心力衰竭心气虚、心阳虚证与肿瘤坏死因子-α及射血分数关系的研究  

Research on the Relationship with TNF-α and EF% in Heart Qi Deficiency and Heart Yang Deficiency in Chronic Heart Failure after Coronary Myocardial Infarction

作　　者：李秋凤[1] 朱明军[2] 刘宏飞 王守富[1] 张关亭[1] 张晓红[1] 

机构地区：[1]河南省中医药研究院,河南郑州450004 [2]河南中医学院第一附属医院,河南郑州450004 [3]浙江省宁波市中医院,浙江宁波315010

出　　处：《世界中西医结合杂志》2011年第2期115-118,121,共5页World Journal of Integrated Traditional and Western Medicine

基　　金："十一五"国家科技支撑计划项目(No.2007BAI20B075)

摘　　要：目的观察冠心病心肌梗死后慢性充血性心力衰竭（CHF）心气虚、心阳虚证患者血清中肿瘤坏死因子-α（TNF-α）水平以及心脏超声左室射血分数（EF%）水平,阐明冠心病心肌梗死后慢性心力衰竭心气虚、心阳虚证与肿瘤坏死因子-α以及射血分数之间的关系。方法收集2006年2月~2008年2月之间临床确诊为冠心病心肌梗死后慢性心力衰竭心气虚证患者38例、心阳虚证患者35例,设正常对照组30例。用放射免疫法测定入选患者血清中TNF-α水平,观察各组患者的心脏超声左室射血分数（EF%）,对比各组指标之间的相关性。结果心气虚组和心阳虚组患者血清中的TNF-α水平高于正常对照组（P〈0.01）,心阳虚组TNF-α水平高于心气虚组（P〈0.01）。心气虚组和心阳虚组患者的射血分数均低于正常对照组（P〈0.01）,心阳虚组的射血分数低于心气虚组（P〈0.01）。心阳虚组患者心功能Ⅳ级者多于心气虚组（P〈0.01）,心气虚组心功能Ⅲ级者多于心阳虚组（P〈0.01）。结论冠心病心肌梗死后慢性心力衰竭心气虚患者心功能优于心阳虚患者,其血清中TNF-α水平与心功能分级（NHYA）呈正相关。为中医辨证冠心病心肌梗死后慢性心力衰竭心气虚、心阳虚证的标准化、客观化研究提供了理论依据。Objective To observe the levels of TNF-α in serum and left ventricular EF% in echocardiogram in the patients with heart qi deficiency and heart yang deficiency in chronic congestive heart failure（CHF）after coronary myocardial infarction so as to clarify the relationship of heart qi deficiency and heart yang deficiency in chronic CHF after coronary myocardial infarction with TNF-α and EF%.Methods 38 cases of heart qi deficiency and 35 cases of heart yang deficiency of CHF diagnosed definitely in clinic were collected from February 2006 to February 2008.30 cases of normal control group were set up.The radioimmunoassay was adopted to determine TNF-α level in serum and left ventricular EF% in echocardiogram was observed in each group.SPSS13.0 statistical analysis software was used to compare the correlation of the indicators in each group.Results TNF-α level in serum in heart qi deficiency group and heart yang deficiency group was higher than that in normal control group（P0.01）.TNF-α level in heart yang deficiency group was higher than that in heart qi deficiency group（P0.01）.EF% in either heart qi deficiency group or heart yang deficiency group was lower than that in normal control group（P0.01）.EF% in heart yang deficiency group was lower than that in heart qi deficiency group（P0.01）.More patients in heart yang deficiency group presented heart function IV grade as compared with heart qi deficiency（P0.01）.More patients in heart qi deficiency group presented heart function III grade as compared with heart yang deficiency（P0.01）.Conclusion The heart function of the patients of heart qi deficiency in chronic CHF after coronary myocardial infarction is superior to that of the patients of heart yang deficiency,in which serum TNF-α level is correlative positively with NHYA so that the theoretic evidence can be provided for the standardization and objectification of heart qi deficiency and heart yang deficiency in chronic CHF after coronary myocardial infarction.

关 键 词：冠心病 心肌梗死 慢性心力衰竭 肿瘤坏死因子-Α 心气虚 心阳虚 

分 类 号：R587.1[医药卫生—内分泌]