慢性心力衰竭患者血浆基质金属蛋白酶-9、肿瘤坏死因子-α及脑钠肽水平变化的临床分析

Change level of plasma matrix metalloproteinase-9 and TNF-α as well as B-type natriuretic peptide in chronic heart failure patients

目的探讨慢性心力衰竭患者血浆基质金属蛋白酶-9、肿瘤坏死因子-α和脑钠肽水平变化及其临床意义。方法采用酶联免疫吸附法测定68例慢性心力衰竭患者(CHF组)和36例健康者(对照组)的血浆MMP-9、肿瘤坏死因子-α和BNP的浓度,采用经胸超声心动图测定左心室收缩末内径、舒张末内径,计算左心室射血分数和左心室短轴缩短率。结果慢性心力衰竭患者组血浆MMP-9、TNF-α和BNP浓度均高于对照组,且随着心力衰竭程度的加重而显著增加(P<0.05);CHF组血浆MMP-9、TNF-α和BNP浓度分别与左心室舒张末内径呈正相关(P<0.05),而与左心室射血分数及左心室短轴缩短率呈负相关(P<0.05),并且MMP-9和TNF-α与BNP之间呈显著正相关(P<0.05);TNF-α和MMP-9之间亦呈显著正相关(P<0.05)。结论心力衰竭患者血浆MMP-9、TNF-α与BNP水平密切相关,TNF-α介导的MMP-9在慢性心力衰竭的发生发展中起重要作用。

Objective To investigate the clinical significance and change of plasma levels of matrix metalloproteinase-9 and TNF-α as well as B-type natriuretic peptide in chronic heart failure patients. Methods MMP-9 and TNF-α as well as BNP levels were detected by ELISA,LVESD and LVEDD were examined by echocardiography in 68 patients with CHF and 36 healthy controls. Results The plasma levels of MMP-9 and TNF- ct as well as BNP of CHF group were higher than those of the control group,and increased with the severity of heart failure（P 〈 0.05）. The levels of MMP-9 and BNP were positively correlated with the left ventricular and diastolic diameter（P 〈 0.05）,and negatively correlated with the left ventricular ejection fraction and left ventricular fraction shorter,and MMP-9 and TNF-ct levels were positively correlated with BNP levels（P 〈 0.05）,MMP-9 levels were also positively correlated with TNF-α levels（P 〈 0.05）. Conclusion Plasma levels of MMP-9 and TNF-α are consistent with the increased level of BNP in patients with CHF,and MMP-9 by TNF- α mediated plays an important role in the development of heart failure.