肿瘤坏死因子α在风心病中的表达及其与心功能关系的研究

The relationship research between the heart function and the tumor necrosis factorαexpression in the rheumatic heart disease patients

目的:探讨肿瘤坏死因子α(TNF-α)在风湿性心脏病(风心病)中的表达及其与心功能关系。方法:选择2009年3月至2012年2月在我院心外科就诊的风心病患者90例作为研究组,另选30例健康体检成人作健康对照组,研究组患者都采用瓣膜手术治疗,研究组患者在手术前后(对照组在体检时)进行TNF-α的检测。结果:①研究组的TNF-α浓度明显高于对照组(P<0.05),并且随着心功能分级的增加,其浓度明显增加(P<0.05)。②所有患者都完成手术,未出现手术并发症。治疗后患者TNF-α逐渐降低(P<0.05),术后第7天已达到对照组水平。TNF-α浓度变化与性别、手术方式、主动脉阻断时间、术后拔管时间与术后住院天数明显相关(P<0.05)。③TNF-α浓度变化与心功能分级有明显相关性(r=0.789,P<0.05)。结论:TNF-α是一个良好的评价风心病心功能的指标,并且能够很好预测瓣膜替换术预后的指标。

Objective ：To investigate the relationship research between the heart function and the tumor necrosis factor α（TNF-α）expression in the rheumatic heart disease patients .Methods：Selected 90 patients with rheumatic heart disease from March 2009 to February 2012 in our hospital as the study group （NYHA Ⅱ 30 were cases ,Ⅲ grade were 40 cases ,Ⅳ grade were 20 cases） ,and selected 30 healthy adults as the control group ,the study group patients were used valvular surgery and were given the detection of TNF-αbefore and after surgery （the control group were detected in the examination） .Results ：① The TNF-αconcentration were significantly higher （P＆lt;0 .05） than those in the study group and with the increasing of cardiac function ,its concentration were significantly increased （P〈0 .05） .② All patients were completed surgery without complications arised .After treatment ,the TNF-αconcentration were decreased （P＆lt;0 .05） ,after the seven days ,it were reached the level of the control group . TNF-αconcentration were significantly correlated to the gender ,surgical approach ,aortic clamping time ,postopera-tive extubation time and postoperative hospital stay （P〈0 .05） .③ TNF-αconcentration was significantly correlated to the cardiac function （r = 0 .789 , P〈0 .05） .Conclusion：TNF-α is a good evaluation of cardiac function index rheumatic heart disease ,and it can better predict the prognosis of valve replacement surgery .