充血性心力衰竭胰岛素抵抗与肿瘤坏死因子-α的相关分析  

The correlation analysis of insulin resistance and tumor necrosis factor-α in congestive heart failure

作　　者：许朝祥[1] 杜心清[1] 许有容[1] 王耀国[1] 

机构地区：[1]福建医科大学附属第二医院心内科,福建泉州362000

出　　处：《临床心血管病杂志》2001年第7期306-308,共3页Journal of Clinical Cardiology

摘　　要：目的 :研究充血性心力衰竭胰岛素抵抗 ( IR)与肿瘤坏死因子 -α( TNF-α)的相关关系及临床意义。方法 :采用放免法对 4 1例充血性心力衰竭患者和 2 6例正常人空腹胰岛素 ( FINS)、TNF-α进行测定 ,选择 FINS、血糖乘积的倒数作为评价心力衰竭状态下的胰岛素敏感性指数 ( IAI) ,对 IAI、心功能分级及 INF- α进行相关分析。结果 :心力衰竭组的 IAI低于对照组〔( - 1.9± 0 .188)∶ ( - 1.4 8± 0 .14 9) ,P <0 .0 0 1〕。并随着心功能的恶化而进一步降低〔( - 2 .0 67± 0 .15 4 )∶ ( - 1.80 4± 0 .12 6) ,P =0 .0 4 6〕,但不同病因组 IAI差异无显著性意义 ( F =1.92 5 8,P =0 .12 72 )。心力衰竭组的 FINS〔( 19.19± 6.78)∶ ( 6.78± 2 .3 5 ) ,P <0 .0 0 1〕、TNF- α〔( 0 .3 4 5±0 .0 9)∶ ( 0 .199± 0 .0 5 ) ,P <0 .0 0 1〕均显著高于对照组 ,且心力衰竭程度越重 ,FINS〔( 2 3 .96± 8.2 2 )∶ ( 16.11±3 .0 6) ,P <0 .0 0 1〕和 TNF-α水平越高〔( 0 .4 2 4± 0 .0 9)∶ ( 0 .2 95± 0 .0 5 ) ,P <0 .0 0 1〕。 TNF-α与 IAI呈负相关 (r =- 0 .74 4 6,P <0 .0 0 1)。结论 :IR和 TNF-α密切相关 。Objective: To explore the relationship between insulin resistance (IR) and plasma tumor necrosis factor α(TNF α) in congestive heart failure (CHF).Method: The levels of fasting plasma insulin and TNF α were determined by means of radioimmunoassay in 41 patients with CHF and 26 normal healthy controls. Insulin sensivtivity index (IAI) was assessed by reverting fasting plasma glucose and insulin product. All parameters in CHF and in normal healthy control were compared. And the correlation between the grade of CHF and the levels of IAI and TNF α were analyzed.Result: Compared to normal healthy control, patients with CHF had significantly higher levels of TNF α 〔( 0.345 ± 0.09 )∶( 0.199 ± 0.05 ),P< 0.001 〕, fasting insulin 〔( 19.18 ± 6.78 )∶( 6.78 ± 2.35 ),P< 0.001 〕 and had lower IAI 〔(- 1.90 ± 0.188 )∶(- 1.48 ± 0.149 ),P< 0.001 〕. The severe the heart failure, the higher the TNF α and the lower IAI level. IAI was correlated with TNF α(r=- 0.744 6 ) but not related to heart failure in etiology.Conclusion: IR and TNF α relate each other and both play important roles in the pathogenesis of CHF.

关 键 词：充血性心力衰竭 胰岛素抵抗 肿瘤坏死因子-Α 

分 类 号：R541.61[医药卫生—心血管疾病]