老年慢性心力衰竭患者肿瘤坏死因子、脑钠肽水平变化及其相关性分析

目的：探讨老年慢性心力衰竭（CHF）肿瘤坏死因子α（TNF-α）以及脑利钠肽水平的变化，并对其进行相关性分析。方法：选择老年CHF患者59例，根据心功能分级，Ⅱ级19例，Ⅲ级25例，Ⅳ级15例；另选心功能正常的老年人36例。所有入选者予以血清BNP、TNF-α测定，并采用彩色多普勒超声测定左心室舒张末内径并计算左室射血分数（LVEF）。结果：与对照组比较，CHF组心功能Ⅲ、Ⅳ级患者TNF-α水平明显升高（P〈0．05），心功能Ⅱ、Ⅲ、Ⅳ级患者血BNP水平明显升高（P〈0．05），并随心功能分级加重而增加。血TNF-α水平与BNP呈正相关（r=0．57，P〈0．05）。CHF患者中血清TNF-α和BNP水平与LVEF比较均呈负相关（F-0．48，r=-0．64，P〈0．05）。结论：老年CHF患者血TNF-α显著升高，并与BNP及LVEF关系密切，是反应CHF患者心功能恶化的重要预测指标。

Changes and Correlation of Tumor Necrosis Factor and Brain Natriuretic Peptide in Patients with Chronic Heart Failure

Objective： To investigate the change of tumor necrosis factor alpha （TNF-e0 and brain natriuretic peptide （BNP） level in elderly patients with chronic heart failure （CHF）, and to investigate their correlation. Methods： 59 elderly patients with CHF were selected, according to the classification of cardiac function, 19 cases of grade Ⅱ, 25 cases of grade Ⅲ, 15 cases of grade Ⅳ; 36 normal elderly subjects were selected as the control group. The detection of BNP and TNF-α was performed on all subjects, and the determination of left ventricular end-diastolic diameter and left ventricular ejection fraction （LVEF） by color Doppler ultrasound was also investigated. Results： Compared with the control group, the concentration of TNF-α in CHF group with cardiac function on grade Ⅲ and Ⅳ increased significantly （P〈0.05）, the concentration of BNP in CHF group with cardiac function on grade Ⅱ, Ⅲ and Ⅳ increased significantly （P〈0.05）, and both increased with the increase of cardiac function classification. Serum TNF-α level was positively correlated with BNP （r=0.57, P〈0.05）. In patients with CHF, serum TNF-α and BNP levels were negatively correlated with LVEF （r=-0.48, r=-0.64, P〈0.05）. Conclusion： The serum TNF-α of elderly patients with CHF increased significantly, and showed relationship with BNP and LVEF, it is an important predict of deterioration of cardiac function in patients with CHF.