肺心病心力衰竭病人血液中肿瘤坏死因子、一氧化氮的含量变化及意义

THE CONTENT CHANGE AND SIGNIFICANCE OF TUMOR NECROSIS FACTOR AND NITRIC OXIDE IN BLOOD OF PATIENTS WITH HEART FAILURE OF COR PULMONALE

目的 :探讨肿瘤坏死因子 (TNF)、一氧化氮 (NO)在肺心病心力衰竭的病理生理过程中的作用。方法 :用放免法测定血清TNF含量 ,用硝酸还原酶法测定血清NO含量 ,用彩色多普勒诊断分析仪测定左、右心室射血分数 (RVEF、LVEF)、肺动脉收缩压 (PASP)。结果 :1.肺心病心衰病人血清TNF、NO含量明显高于对照组(P <0 0 1)。 2 .肺心病不同心功能组TNF、NO明显升高 ,各组间比较有显著差异 (P <0 .0 1) ,升高幅度与心衰程度呈正相关。TNF、NO与PASP呈显著正相关 (P <0 .0 1) ,与RVEF、LVEF呈显著负相关 (P <0 .0 1)。结论 :肺心病心衰病人TNF、NO含量明显升高 ,TNF对心肌起负性肌力作用 ,在心脏收缩功能障碍中起重要的作用。

Objective:To investigate the effect of tumor necrosis factor(TNF)? nitric oxide (NO) on heart failure of chronic cor pulmonale. Methods: The serum concentration of TNF, NO, pulmonary artery systolic pressures (PASP), right and left ventricular ejection fraction (RVEF,LVEF) were determined in all patients and normal controls. Results:1. The serum concentration of TNF,NO were greatly increased in all patients, compared with that of controls. 2. The levels of TNF,NO were significantly increased in all patients with heart failure. The levels of TNF,NO were positively correlated with PASP, negatively correlated with RVEF,LVEF (P<0 01). The higher level of TNF, NO, the more severe the heart failure. Conclusion: The levels of TNF, NO were higher in all patients with heart failure of chronic cor pulmonale. TNF has negative isotropic effects on the myocardium. It might play an important role in the myocardial dysfunction.