缺血性心肌病患者血红蛋白水平、细胞因子、神经内分泌激素及左室功能的相关性研究

Relationship between hemoglobin concentration,cytokine,neurohormonal activation and cardiacfunction in anemicpatients with ischemic cardiomyopathy

目的探讨缺血性心肌病(ICM)患者血红蛋白水平、细胞因子、神经内分泌激素及心功能变化的相关性。方法测定入选121例慢性充血性心力衰竭(CHF)患者的血红蛋白(Hb)水平、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和血管紧张素Ⅱ(AngⅡ)的变化;超声心动图测量左室射血分数(LVEF),评价心功能;按Hb水平分为ICM贫血组和非贫血组,同时选择27例正常人作为对照组。结果ICM贫血组TNF-α、IL-6和AngⅡ水平明显高于非贫血组,而LVEF显著低于非贫血组(P<0.01);随着TNF-α、IL-6和AngⅡ水平升高,Hb和LVEF明显降低(P<0.01);ICM患者Hb水平和LVEF与TNF-α、IL-6和AngⅡ水平呈负相关,Hb水平与LVEF呈正相关(P<0.01)。结论ICM患者神经内分泌激素和细胞因子激活影响并促进贫血与心力衰竭的病理生理过程。

Objective To study the relationships between hemoglobin concentration, cytokine, neurohormonal activation and cardiacfunction in anemicpatients with ischemic cardiomyopathy. Methods Hemoglobin concentration, serum TNF- α, IL- 6 and Ang Ⅱ in 121 patients with ischemic eardiomyopathy were measured,left ventrieular ejection fraction （LVEF） by eehoeardio-graphy, according to hemoglobin concentration, these patients was distributed the Anemic group and the Non - Anemic group, contrasting to 27 good health person. Results The levels of serum TNF - α, IL - 6 and Ang Ⅱ in the anemic patients group were-higher than those in the non - anemic group subjects, but LVEF were lower. With the increase of anemia severity, the levels of serum TNF - α, IL - 6 and Ang Ⅱ significantly increased ; there was a positive correlation between LVEF and the levels of serum TNF-α,IL- 6 and Ang Ⅱ （ P 〈 0.01 ）, and a negative correlation between LVEF and Hb concentration. Conclusion The levels of cytokine, neurohormonal activation promote the pathophysiological procedure between cardiac failure and anemicin ICM.