心力衰竭患者肿瘤坏死因子样凋亡微弱诱导剂的血清表达及意义  

Expression and Clinical Value of Serum Tumor Necrosis Factor-like Weak Inducer of Apoptosis in Heart Failure

作　　者：李伟龙[1] 武凌宁[2] 

机构地区：[1]湖北省咸宁市通城县人民医院内二科,咸宁437400 [2]湖北省黄石市大冶有色金属公司总医院,黄石435000

出　　处：《微循环学杂志》2013年第3期37-39,I0002,共4页Chinese Journal of Microcirculation

摘　　要：目的:探讨心力衰竭患者血清肿瘤坏死因子样凋亡微弱诱导剂(TWEAK)表达的临床意义。方法:选择103例慢性心力衰竭患者,根据心脏超声结果分为射血分数正常的心衰组(HFNEF组,n=19)与射血分数降低的心衰组(HFREF组,n=84);根据NYHA分级分为心功能Ⅰ、Ⅱ、Ⅲ、Ⅳ级组。选择同期32名健康体检者为对照组。所有被研究者接受心脏超声、血清TWEAK与脑钠肽(BNP)检测,比较各组间各指标的差异。同时比较发病6个月内,两心衰患者组心脑血管事件发生率的差异。结果:与正常对照组比较,两心衰组血清TWEAK水平明显降低,BNP水平明显升高(P<0.05或P<0.01),HFREF组尤为显著(P<0.01)。随着心功能的恶化,血清BNP水平明显升高,血清TWEAK水平显著下降。直线相关分析显示:HFNEF组和HFREF组,血清TWEAK与BNP均呈负相关(r=-0.74,P<0.05;r=-0.85,P<0.05)。随访6个月,HFREF组患者心脑血管事件发生率明显高于HFNEF组患者(P<0.05)。结论:血清TWEAK与血清BNP相关性良好,其可能在心衰的临床诊断、分级中具有重要的应用价值。Objective: To investigate the changes of serum tumor necrosis factor-like weak inducer of apoptosis (TWEAK) levels in patients with heart failure (HF) and its clinical value. Method: 103 HF patients were enrolled in this study and divided into 2 groups: heart failure with normal left ventricular ejection fraction congestive group group (HFNEF, n=19) and heart failure with reduced left ventricular ejection fraction congestive group (HFREF, n=84) according to the echocardiography. They were also divided into 4 groups: NYHA I, II, III, IV groups according to the cardiac function. 32 healthy people were set as the control group. All patiens were undergone echocardiograph and serum brain natriuretic peptide (BNP) was detected. Serum TWEAK levels were measured by ELISA. Results: Compared with the control group, lower TWEAK and higher BNP levels were occurred in the HFNEF group and HFREF group (P<0.01), especially in the latter; Increased serum TWEAK levels were associated with the severity of cardiac function. Linear correlation analysis showed that the levels of serum TWEAK was negative correlated with serum BNP levels both in HFNEF group and HFREF group (r=-0.74,P<0.05;r=-0.85,P<0.05); 6 months follow-up, higher cardiovascular and cerebrovascular events were occurred in HFREF group than those in HFNEF group (P<0.01). Conclusion: Serum TWEAK levels in patients with heart failure were significantly decreased, especially in patients with HFREF. TWEAK might be an important predictor of heart failure.

关 键 词：心力衰竭 肿瘤坏死因子样凋亡微弱诱导剂 脑钠肽 左室射血分数 

分 类 号：R541.6[医药卫生—心血管疾病]