急性毛细支气管炎并心衰患儿血小板活化因子，血小板源生长因子的表达及临床意义

目的：探讨血小板活化因子（PAF）、肿瘤坏死因子-α（TNF-α）及血小板源生长因子（PDGF）水平变化在毛细支气管炎并急性心衰的变化，探讨它们在该病的发病中的作用。方法：58例心衰组患儿分别于治疗前和临床症状消失后采用双抗体夹心ABC．ELISA法检测PAF、TNF-α及PDGF血清含量，设正常对照组40例比较。结果：心衰组PAF治疗前为370．57±23．6ng／L，明显高于对照组的56．78±19．6ng／L，组间比较差异具有非常显著性意义（t=15．95，P〈0．001）；治疗后恢复至49．63±14．5ng／L，与正常对照差异不明显；治疗前后比较，差异具有非常显著性意义（t=3．70，P〈0．001）。TNF-α治疗前为457．4±40．5ng／L，明显高于对照组的148．8±21．6ng／L，组间比较差异具有显著性意义（t=2．135，P〈0．05）；治疗后恢复至162．6±37．61ng／L，与正常对照差异不明显；治疗前后比较，差异具有非常显著性意义（t=7．25，P〈0．01）。PDGF治疗前为596．23±199．43）ng／L，较对照组259．76±69．58ng／L增高，组间比较，差异具有非常显著性意义（t=-25．52，P〈0．01）；治疗后降为272．83±116．96ng／L，较治疗前明显恢复，组间比较差异均具有显著性意义（t=7．66，P〈0．01）。结论：结果表明，PAF、TNF-α、PDGF作为炎症介质不仅参与心衰的发病过程，还提示细胞外基质的异常在心衰发病学中的重要地位。

Expression of Platelet-activating Factor and Platelet-derived Growth Factor in Bronchiolitis with Acute Heart Failure and Their Clinical Significance

Objective： The present study was designed to study the level changes and effects of platelet-activating factor, tumor necrosis factor-a and platelet-derived growth factor in Bronchiolitis with acute heart failure. Methods： Set heart failure group （n=58 cases）, and healthy control group （n=40 cases）. Collect the patients＇ blood samples before treatment and after clinical symptoms disappeared. The levels of serum PAF, TNF-a and PDGF were detected by ABC-ELISA method. Results： Before treatment, PAF of heart failure group was significantly higher than healthy control group. The difference between groups was statistically significant （t=3.70, P〈0. 001）. After clinical symptoms disappeared, PAF of heart failure group had no statistically significant difference with healthy control group. Before and after treatment, the difference was statistically significant （t=3.70, P〈0.001）. TNF-α of heart failure group was significantly higher than healthy control group. The difference between groups was statistically significant （t=2.135, P〈0.05）. After clinical symptoms disappeared, TNF-a of heart failure group had no statistically significant difference with healthy control group. Before and after treatment, the difference was statistically significant （t=7.25, P〈0.01）. PDGF of heart failure group was significantly higher than healthy control group. The difference between groups was statistically significant （t=-25.52, P 〈0.01）. Before and after treatment, the difference was statistically significant （t=7.66, P 〈0.01）. Conclusion： As inflammatory mediators, platelet-activating factor, tumor necrosis factor-α and platelet-derived growth factor involved in the pathogenesis of heart failure, and abnormal extracellular matrix has an important part in the pathogenesis of heart failure.