冠心病患者可溶性肿瘤坏死因子受体的改变与临床意义

Changes of Serum Soluble Tumor Necrosis Factor Receptor in Coronary Heart Disease and its Clinical Significance

目的：观察冠心病患者可溶性肿瘤坏死因子受体（ＳＴＮＦＲ）的改变与临床意义。方法：ＳＴＮＦＲ采用酶联免疫双抗体夹心法测定。结果：血清ＳＴＮＦＲ（ｎｇ／ｍｌ）在急性心肌梗死患者（３．５５±２．０１，ｎ＝２９）和冠心病心肌缺血患者（１．９９±０．６２，ｎ＝２３）中均较正常对照有所升高（０．９３±０．２９，ｎ＝６１，Ｐ均＜０．０１），急性心肌梗死并发心力衰竭死亡时ＳＴＮＦＲ升高达正常值７．７倍（７．２３±１．６０，ｎ＝５），心肌缺血患者中心功能ＩＩ、ＩＶ级（２．５３±０．４６，ｎ＝７）较Ｉ、Ｉ级者（１．７３±０．５０，ｎ＝１６）升高明显（Ｐ＜０．０１）。结论：冠心病患者中ＳＴＮＦＲ水平与病情严重程度密切相关，并能预测急性心肌梗死患者预后。

Objective:To identify whether there are changes of serum soluble tumor necrosis factor receptor (STNFR) in patients with coronary heart disease (CHD) and analyse its clinical significance. Methods:Fifty two cases with CHD were studied.Serum STNFR was examined by enzyme linked immunosorkent assay (ELISA). Results:STNFR both in patients with acute myocardial infarction (AMI)(3 55±2 01 ng/ml, n =29) and with myocardial ischemia (1 99±0 62 ng/ml, n =23)were higher than that in control(0 93±0 29 ng/ml, n =61, p <0 01).In AMI patients died of heart failure,the STNFR(7 23±1 60 ng/ml, n =5) was significantly increased to 7 7 fold of control, while in myocardial ischemic patients,the STNFR elevated with the worsening of heart function.STNFR in patients with heart function (NYHA) of III and IV classes(2 53±0 46 ng/ml, n =7) was higher than in those of I and II classes (1 73±0 50 ng/ml, n =16, p <0 01). Conclusion:STNFR level is closely correlated to the severity of patients with CHD, and it might predict the prognosis of acute myocardial infarction.