心力衰竭患者血浆TNF-α及脑钠素水平的变化及β-阻滞剂对其的影响

Changes of Plasma Brain Natriuretic Peptide Levels in Patients of Different Heart Disease with Congestive Heart Failure

目的:观察心力衰竭(HF)患者血浆肿瘤坏死因子-α(TNF-α)及脑钠素(BNP)水平的变化,及其与心功能分级的关系。探讨TNF-α及BNP在HF发病机制中所起的作用以及β-阻滞剂对HF患者TNF-α及BNP水平的影响。方法:116例HF患者,随机分为常规治疗组和卡维地洛治疗组,予以药物干预8周,检测治疗前后血浆TNF-α及BNP水平,健康对照组68例,同时检测血浆TNF-α及BNP水平。结果:HF组血浆TNF-α及BNP水平与正常对照组相比显著升高(P＜0．01),且与临床心功能分级呈明显正相关(P＜0．01)。HF患者经卡维地洛治疗后血浆TNF-α及BNP水平明显低于治疗前(P＜0．05),而常规治疗组治疗前后无明显差异(P＞0．05)。结论:HF患者血浆TNF-α及BNP水平显著升高,与HF严重程度呈正相关。卡维地洛能下调HF TNF-α及BNP水平,可能是其治疗HF有益的作用机制之一。

Objective： To study the mechanism of the elevation of plasma TNF - α and BNP in patients with chronic congestive heart failure （CHF）. Moreover, the effects of carvedilol were investigated.Methods： The levels of TNF - α were measured in 116 cases with CHF and in 68 normal controls using ELISA test. 116 patients were divided into two groups. One group were treated with traditional drugs. The second group were treated with carvedilol for 4 Weeks except traditional drugs.Results： The levels of TNF - α and BNP were related to the cardiac function. And piasma TNF - α and BNP decreased in patients suffered from CHF after 8 weeks treated with carvedilol. Conclusion： There was a positive correlation between the levels of plasma TNF - α and BNP and CHF. Decreasing of plasma TNF - α and BNP by carvedilol may contribute to the beneficial effects of carvedilol in patients with heart failure.