老年充血性心力衰竭患者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 patients with congestive heart failure in the elderly

作　　者：杜心清[1] 许朝祥[1] 许有容[1] 王耀国[1] 刘华玲[1] 

机构地区：[1]福建医科大学附属第二医院心内科,泉州市362000

出　　处：《中华老年医学杂志》2001年第4期252-254,共3页Chinese Journal of Geriatrics

基　　金：福建省高等教育委员会科研基金赞助 (JB980 86 )

摘　　要：目的　研究老年充血性心力衰竭 (心衰 )患者胰岛素抵抗 (IR)与肿瘤坏死因子 α(TNF α)的相关关系及临床意义。　方法　采用放射免疫分析法测定 5 2例老年充血性心力衰竭患者、36例老年健康志愿者和 30例非老年健康志愿者空腹胰岛素、TNF α ,选择空腹胰岛素与血糖乘积的倒数(IAI)作为评价老年人心衰状态下的胰岛素敏感性指数 ,对IAI、左室射血分数 (LVEF)、心功能分级及TNF α进行相关分析。　结果　老年心衰组的IAI低于老年健康组 (- 1 75± 0 17对 - 1 36± 0 16 ,P <0 0 5 ) ,并随着心功能的恶化而进一步降低 (- 1 87± 0 16对 - 1 6 8± 0 15 ,P <0 0 5 ) ;但不同病因组IAI差异无显著性 (F =2 0 2 ,P >0 0 5 )。老年心衰组的空腹胰岛素和TNF α均显著高于老年健康组〔(18 2 9± 6 80 )对 (8 78± 3 35 )mIU/L)和 (0 36± 0 13)对 (0 2 1± 0 12 ) μg/L ,P <0 0 5〕 ,且心衰程度越重 ,空腹胰岛素和TNF α的水平越高〔(2 2 46± 9 12 )对 (16 41± 5 0 6 )mIU/L和 (0 41± 0 17)对 (0 31± 0 15 ) μg/L ,P <0 0 5〕。老年心衰患者TNF α与IAI呈显著负相关 (r=- 0 76 ,P <0 0 5 )。　 结论　老年心衰患者的IAI和TNF α存在着相关性 ,IAI和TNFObjective To explore the relationship between insulin resistance (IR) and plasma tumor necrosis factor α(TNF α) in patients with congestive heart failure (CHF) in the elderly. Methods The levels of fasting plasma insulin (FINS) and TNF α were determined by means of radioimmunoassay in 52 elderly patients with CHF and 36 elder healthy controls. Insulin sensitivity of CHF patients was assessed using reciprocal of the product of fasting plasma insulin and glucose (IAI). The correlation between the grades of cardiac function, left ventricular ejection fraction(LVEF) and IAI of the CHF patients and TNF α were analyzed. Results Compared to the elder healthy controls, elder patients with CHF showed significantly higher levels of TNF α〔(0 36±0 13) μg/L vs (0 21±0 12) μg/L, P <0 05〕 and FINS 〔(18 29±6 80) mIU/L vs (8 78±3 35)mIU/L , P <0 05 〕 and lower IAI 〔(-1 75±0 16 ) vs (-1 36±0 16), P <0 05〕 It was also showed that the more severe the heart failure, the higher the TNF α and the lower the IAI IAI was correlated markedly with TNF α in elder patients with CHF (r=-0 76, P <0 05 ), but no correlation with the etiology of CHF was found. Conclusions In elder CHF patients, IAI and TNF α correlated each other; the levels of IAI and TNF α maybe used as referential markers in assessing the degree of CHF.

关 键 词：充血性心力衰竭 胰岛素抵抗 高胰岛素血症 肿瘤坏死因子 老年人 

分 类 号：R541.61[医药卫生—心血管疾病]