CHF患者ET、CGRP和TNF-α的变化关系及其对LVMI和MWS的影响

The Relationship Between ET、CGRP and TNF-α and Effect of Them on LVMI and MWS in Patients with CHF

目的:探讨充血性心力衰竭(CHF)患者血浆内皮素(ET)、降钙素基因相关肽(CGRP)和肿瘤坏死因子-α(TNF-α)的变化关系及其对LVMI和MWS的影响。方法:对入选的121例CHF患者测定了血浆ET、CGRP和TNF-α水平,超声心动图测量左室射血分数(LVEF),评价心功能;计算LVMI和MWS;同时选择27例正常人作为对照组。结果:CHF患者CGRP水平低于正常对照组,而血浆ET、TNF-α水平以及MWS和LVMI高于对照组(P<0.01);随着心功能恶化,CGRP水平逐渐降低,而血浆ET、TNF-α水平以及MWS和LVMI逐渐升高;CHF患者MWS和LVMI与CGRP水平呈负相关,而与血浆ET、TNF-α水平呈正相关(P<0.01)。结论:CHF患者ET、CGRP和TNF-α水平参与了CHF心室重构病理生理发生发展过程。

Objective: To study the changes of endothelin(ET),calcitonin gene related peptide(CGRP) and tumor necrosis factor-α(TNF-α) and effect of them on left ventricular mass index(LVMI),mean wall stress(MWS) in patients with congestive heart failure(CHF).Methods: The plasma levels of ET,CGRP and TNF-α in 121 CHF patients were measured.Left ventricular ejection fraction(LVEF) was from echocardiography.LVMI,MWS were calculated.Results: Level of CGRP in patients with CHF were lower than that in control group,and The plasma levels of ET and TNF-α were higher than that in control subjects.The significant decrease in CGRP was correlated with the increase of NYHA;in contrast to the changes of ET and,TNF-α on LVMI,and MWS.LVMI and MWS were positive correlation with the levels of ET,TNF-α(P<0.01),and LVMI and MWS was negative correlation with CGRP.Conclusions: The change of ET and CGRP as well TNF-α could play roles in pathophysiological and pathogenetic mechanism of ventricular remodeling in patients with CHF.