充血性心力衰竭治疗前后血浆肿瘤坏死因子变化的研究

Study of plasma tumor necrosis factor before and after the treatment of patient with congestive heart failure.

为探讨肿瘤坏死因子(TNF)在充血性心力衰竭(CHF)发生、发展过程中的意义,我们测定了40例CHF患者治疗前后外周血中的TNF、血浆内皮素(ET)、心钠素(ANP)、前列环素(PGI_2)的浓度.其中风湿性心脏病28例,冠状动脉粥样硬化性心脏病7例,扩张型心肌病3例;先心病2例;平均年龄42±11.1岁.心功能Ⅱ级9例,Ⅲ级22例,Ⅳ级9例.并与30例正常人作对照.结果发现TNF、ET、ANP浓度均显著高于对照组(P<0.01),CHF治疗前的TNF、ET、ANP浓度与治疗后比较均有非常显著差异(P<0.01),且与CHF的严重程度相一致.TNF与ET、ANP呈显著正相关.PGI_2在CHF患者治疗前后及与对照组比较差异无显著性(P>0.05).提示TNF参与了CHF的发生和发展过程,TNF可作为CHF的一个重要指标.

In order to explore the meaning of tumor necrosis factor (TNF) in the ocfucrence and development of congestive healt failure Peripheral blood concentration of TNF. endothelin (ET) 、a-trial natriuretic polyeptide (ANP)、prostacyclin(PGI2) was measured in pre and posttreatment of 40 CHF including rheumatic heart disease 28,coronary heat disease 7,dilated cardiomyopathy 3. congenital heart disease2. Mean age is 42±11. lyr. Heart performance staging: Ⅱ8,Ⅲ26. Ⅳ6. 30 normal individuals were used as comparative group. The result showed that concentration of TNF、ET、ANP were remarkably thicker than of comparative group. It had significant difference between pretreatment and posttreatment and correlated with the severely of CHF. TNF showed remarkable positive correlation with ET、ANP. While the concentralion of PG I 2 had no significant difference either between pre and post-treatment or compared with healthy group. It proves that TNF lakes part in the occurence and development of CHF、TNF can be an valuable index of CHF.