血清可溶性肿瘤坏死因子样弱凋亡诱导因子水平与扩张型心肌病患者左心室重构的关系

Serum level of sTWEAK and its relationship with left ventricule remodeling in patients with dilated cardiomyopathy

目的探讨扩张型心肌病(DCM)患者血清可溶性肿瘤坏死因子样弱凋亡诱导因子(sTWEAK)水平变化及其与血清N-末端脑钠肽前体(NT-proBNP)和左室质量指数(LVMI)的相关性。方法选取DCM患者100例(DCM组)和非心衰患者60例(对照组),以酶联免疫吸附法检测两组血清sTWEAK和血清NT-proBNP水平,应用超声心动图测定LVMI。结果 DCM组血清sTWEAK水平低于对照组,其血清NT-proBNP水平及LVMI均高于对照组(P均<0.05)。DCM组血清sTWEAK水平与其心功能NYHA分级无关,但与NT-proBNP、LVMI显著负相关(r分别为-0.524、-0.337,P均<0.05),在调整性别、年龄、体质量指数、总胆固醇、低密度脂蛋白、心率、心功能NYHA分级等影响因素后,上述相关性仍然存在;多元逐步回归分析显示,DCM患者血清sTWEAK水平受LVMI的影响。结论 DCM患者血清sTWEAK水平降低,并能反映DCM患者左室重构的严重程度。

Objective To investigate the changes of serum soluble tumor necrosis factor-like weak inducer of apoptosis （sTWEAK） in patients with dilated cardiomyopathy （DCM） and its relationship with plasma N-terminal pro-natriuretic peptide （NT-proBNP） and left ventricular mass index （LVMI）. Methods One hundred DCM patients （DCM group） and 60 patients without heart failure （ control group） were enrolled. The levels of serum sTWEAK and NT-proBNP were determined by ELISA, and LVMI was measured by echocardiography. Results The level of serum sTWEAK in the DCM group was significantly lower than that in the control group, but the levels of NT-proBNP and LVMI were significantly higher than those in the control group （ all P 〈 0.05 ）. The level of serum sTWEAK in the DCM group was not correlated with NYHA classification, but it was negatively correlated with NT-proBNP and LVMI （ r = -0. 524, r = -0. 337, all P 〈 0. 05）, and this correlation still existed after adjusting gender, age, body mass index, total cholesterol, low-density lipoprotein, hea/t rate, NYHA classification and so on. Multiple stepwise regression analysis showed that serum sTWEAK level was affected by LVMI in DCM patients. Conclusion The level of serum sTWEAK decreases in DCM patients and it could reflect the severity of left ventricular remodeling.