组织因子、白介素-6和血管内皮生长因子对CHF患者预后的判断价值

Prognostic value of interleukin-6,tissue factor and vascular endothelial growth factor levels in congestive heart failure

目的:研究组织因子(tissuefactor,TF)、白细胞介素-6(interleukin-6,IL-6)和血管内皮生长因子(vascular endothelial growth factor,VEGF)在充血性心力衰竭(CHF)患者预后中的地位。方法:选择59例CHF患者和20例健康者,应用酶联免疫吸附法(ELASA)检测血浆中各细胞因子的含量。结果:与对照组相比,CHF患者血浆中TF、IL-6与VEGF含量明显升高(P<0.05);1年内发生心脏事件的TF、IL-6和VEGF含量分别为(267±32)pg/mL、(412±27)pg/mL和(148±12)pg/mL,与未发生心脏事件患者血浆中细胞因子含量相比,差异有显著性(P<0.05);线性相关分析IL-6、VEGF含量与TF含量成正相关(r=0.589、r=0.232,P<0.0001);Logistic多因素回归中年龄、糖尿病、甘油三酯、左心室射血分数(≤30%)、IL-6和TF与CHF患者预后成正相关,VEGF未进入回归模型,TF和IL-6与CHF患者的预后密切相关(r=5.12、r=6.34,P<0.012、P<0.011)。结论:血浆中IL-6和TF的含量对CHF患者预后有判断价值,IL-6和VEGF的分泌增多是血浆中TF升高的原因之一。

Objective To evaluate the prognostic value of interleukin-6(IL-6),tissue factor(TF) and vascular endothelial growth factor(VEGF) levels in congestive heart failure(CHF). Methods Fifty-nine consecutive out-patients with chronic stable CHF were recruited and followed for 1 year. The plasma levels of IL-6,TF and VEGF were determined by ELASA in CHF and healthy individual(n=20) as control. Results The plasma levels of TF IL-6 and VEGF in patients with CHF who suffered heart event within 1 year were obviously increased to TF,IL-6 and VEGF were (267±32)pg/mL,(412±27)pg/mL and (148±12)pg/mL,respectively,and higher significantly than control groups(P< 0.05,0.05 and 0.05) and those in the patients without the heart event. There was the strongly positive relationship between the levels of IL-6,VEGF and TF in CHF with heart event. Logistic regression of multiple factors showed that factors including age,diabetes mellitus,LVEF(≤30%),IL-6 and TF except VEGF had the significant predictive values on the prognosis of CHF patients. Conclusion Plasma levels of IL-6 and TF are of the important value of predicting the poor prognosis of chronic CHF,the increased IL-6 may be one of the important reasons of increased TF.