TNF-αsICAM-1BNP在扩张型心肌病及缺血性心肌病中的不同变化和临床意义

The diversification and clinical significance of TNF-α, sICAM-1 and BNP in DCM and ICM

目的研究肿瘤坏死因子-α（TNF-α）、可溶性细胞间粘附因子-1（sICAM-1）及脑钠肽（BNP）在扩张型心肌病（DCM）和缺血性心肌病（ICM）中的不同变化，并探讨其临床意义。方法对76名DCM和64名ICM患者进行心功能分级并检测血清中TNF-α、sICAM-1及BNP浓度，组内和组间进行比较。结果TNF-α、sICAM-1和BNP在两组间均随着心功能恶化而升高（P〈0．01）。在相同心功能间，TNF-α，sICAM-1在DCM组明显高于ICM组（P〈0．01），而BNP则变化不显著（P〉0．05）。结论DCM患者始终存在着免疫损伤和炎症，检测TNF-α、sICAM-1对DCM及ICM鉴别诊断有临床意义。BNP是反映心功能不全的指标，对二者的鉴别诊断意义不大。

Objective To study the diversification of TNF-α, sICAM-1 and BNP in DCM and ICM, and to discuss the chinical significance of than. Methods 76 patients were DCM group and 64 patients were ICM group. We graded the 140 patients according to the NYHA classification and detected concentrations of TNF-α, sICAM-1 and BNP in patients＇ serum, then we compared the data within and between the two groups. Results The higher the NYHA classification of the patients, the higher the concentrations of TNF-α, sICAM-1 and BNP in both groups（ P 〈 0.01 ）. Among the patients with the same NYHA classification, the concentrations of TNF-α, sICAM-1 in DCM group is significantly higher than those in ICM group（P 〈0.01 ） ,while the diversifications of BNP concentration in the two groups were not observable （P 〉 0. 05 ）. Conclusions As the immune injure and inflammation is always existed in DCM patients, to detect the concentrations of TNF-α, sICAM-1 has chinical significance for us to distinguish DCM from ICM. But for BNP, as it is one of the indexes of heart failure, there is almost no chinical significance.