摘要
目的测定收缩性心力衰竭(CHF)患者血清脂联素(Adp)、高敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)的变化,分析Adp水平与炎性反应介质及心力衰竭严重程度的关系。方法选取2005年6月～2006年7月住院的CHF患者80例,健康对照组40例。CHF组按NYHA分级分为II、III、IV级。应用放射免疫法检测血清Adp,酶联免疫吸附法检测TNF-α、IL-6、hs-CRP。对CHF组心功能III、IV级患者行Swan-Ganz导管血流动力学检查测定心指数(CI)和肺毛细血管嵌压(PCWP)。结果CHF组患者血浆Adp浓度及hs-CRP、TNF-α、IL-6均明显高于健康对照组(P<0.01),且均随着NYHA分级程度的加重而显著增加(P<0.05)。Adp浓度与hs-CRP(r=-0.34,P<0.05)、TNF-α(r=-0.57,P<0.01)、IL-6(r=-0.52,P<0.01)呈显著负相关,与CI(r=0.36,P<0.05)呈显著正相关,与PCWP无相关性。CHF组III、IV级患者随心功能的快速改善,Adp浓度显著减少(P<0.01)。TNF-α为Adp水平的独立影响因素。结论随心力衰竭严重程度的增加,血清中脂联素浓度显著增加,并且与血清炎性介质呈显著负相关。随心功能的快速改善,Adp浓度显著减少。Adp在CHF病理生理过程中可能具有重要的抗炎性作用。
Objective To study the relationship between the levels of serum adiponectin （Adp）, high-sensi- tive C-reactive protein （hs-CRP）, tumor necrosis factor alpha （TNF-α） and interleukin-6 （IL-6） and inflammatory reaction medium as well as the severity of heart failure in patients with congestive heart failure（CHF）. Methods 80 patients with CHF admitted into our hospital from June 2005 to July 2006 were divided into 3 subgroups according to New York Heart Association （NYHA） functional class. 40 healthy subjects were used as control group. The serum levels of Adp was measured by radioimmunoassay. The serum levels of hs-CRP, TNF-α, IL-6 were detected by enzyme-linked immunosorbent assay （ELISA）,and cardiac index （CI） and pulmonary capillary wedge pressure （PCWP） of cardiac hemodynamics were determined by Swan-Ganz catheterizationin patients with NYHA Ⅲ-Ⅳ. Results The serum Adp levels in CHF group were significantly increased according to the severity of NYHA class, as compared with those in control group （ P 〈 0.01）. Similarly, serum levels of hs-CRP and TNF-α and IL-6 were significantly increased in accordance with the NYHA class, as compared with those in control group （ P 〈 0.01 ）. The serum Adp levels were negatively correlated with those of hs-CRP （ r = - 0.34, P 〈 0.05） and TNF-α（ r = - 0.57, P 〈 0.01） as well as IL-6 （ r = -0.52, P 〈 0.01）, however, which were positively correlated with those of CI （ r = 0.36, P 〈 0.05）, but there was no correlation with PCWP. In NYHA Ⅲ and Ⅳ subgroups, according to the prompt improvement in cardiac function, the levels of Adp was significantly reduced （ P 〈 0.01 ）. By multiple regression analysis, serum TNF-α level （OR 3.2,95 %, CI 1.5-7.3, P=0.025） was an independent factor wich effected Adp concentration. Conclusion The serum Adp levels increase with the severity of CHF, moreover, they are negatively correlated with the serum levels of hs-CRP mad TNF-α as well as IL-6. The Adp may have an important anti-inflammatory effect du ring the pathological and physical process of CHF.
出处
《疑难病杂志》
CAS
2007年第10期581-583,共3页
Chinese Journal of Difficult and Complicated Cases
