血清肿瘤坏死因子-α、核因子-κΒ与慢性心力衰竭病人心功能及预后的关系

Correlations of serum TNF-α,NF-κΒ with cardiac function and prognosis in patients with chronic heart failure

目的观察慢性心力衰竭(chronic heart failure,CHF)病人血清肿瘤坏死因子-α(TNF-α)、核因子-κΒ(NF-κΒ)浓度变化,探讨其与CHF病人心功能及预后的关系。方法选取2015年5月至2016年1月期间在宣城市人民医院就诊的52例CHF病人(CHF组)和45例健康体检人员(对照组),采用酶联免疫吸附法(ELISA)测定受试者血清TNF-α、NF-κΒ水平;比较CHF组与对照组以及不同心功能分级CHF亚组间血清TNF-α、NF-κΒ水平;采用logistic回归模型分析影响CHF病人生存的危险因素。结果 CHF组与对照组比较,血清TNF-α[(17.5±4.4)ng/mL比(5.3±1.2)ng/mL]、NF-κΒ[(46.3±7.5)pg/mL比(16.5±4.6)pg/mL]显著升高,两组间差异有统计学意义(P<0.05);血清TNF-α、NF-κB水平随心衰加重而升高,NYHAⅡ级、NYHAⅢ级、NYHAⅣ级三个亚组间血清TNF-α、NF-κB差异有统计学意义(P<0.05); logistic回归分析提示血清TNF-α(OR=1.409,95%CI:1.125～1.765,P=0.003)、NF-κB(OR=1.465,95%CI:1.147～1.872,P=0.002)水平是影响CHF病人生存的危险因素。结论血清TNF-α、NF-κB水平与CHF病人心功能状况相关,可作为评价CHF预后的指标。

Objective To observe the change of serum TNF-αand NF-κΒin patients with chronic heart failure(CHF),and to explore its relationships with cardiac function and prognosis value for CHF patients.Methods Fifty-two patients with CHF(CHF group)and 45 volunteers received health examination(control group)in Xuancheng People s Hospital from May 2015 to January 2016 were enrolled in the study.Enzyme-linked immunosorbent assay(ELISA)were used to test the concentration of TNF-αand NF-κB in the blood.Serum levels of TNF-αand NF-κB were compared between the CHF group and the control group as well as subgroups of the CHF group with different cardiac function grade.Logistic regression model was used to analyze the risk factors affecting the survival of CHF patients.Results Compared with the control group,serum TNF-α[(17.5±4.4)ng/mL vs.(5.3±1.2)ng/mL]and NF-κΒ[(46.3±7.5)pg/mL vs.(16.5±4.6)pg/mL]were significantly increased in the CHF group,and the differences were statistically significant(P<0.05);serum TNF-αand NF-κB increased with the aggravation of CHF,and the differences of serum TNF-αand NF-κB between NYHA class II,NYHA class III and NYHA class IV were statistically significant(P<0.05).Logistic regression analysis showed that the levels of serum TNF-α(OR=1.409,95%CI:1.125-1.765,P=0.003)and NF-κB(OR=1.465,95%CI:1.147-1.872,P=0.002)were risk factors affecting the survival of CHF patients.Conclusion Serum levels of TNF-αand NF-κB are correlated with the cardiac function and may be used as indexes to evaluate the prognosis of CHF patients.