摘要
目的研究老年慢性心力衰竭(CHF)患者血红蛋白(Hb)水平变化与血清肿瘤坏死因子-α(TNF-α)及心功能的关系。方法对入选的121例老年CHF患者测定了Hb和血清TNF-α水平,超声心动图测量左室射血分数(LVEF),评价心功能;按Hb水平分为CHF贫血组和非贫血组,同时选择27例老年健康人作为对照组。结果CHF患者Hb水平和LVEF低于正常对照组,而血清TNF-α水平高于正常对照组(P均<0.01);随着心功能恶化,Hb水平和LVEF则逐渐降低,而TNF-α水平逐渐升高,明显高于非贫血组CHF患者和健康对照组(P<0.01)。多因素逐步回归分析,TNF-α水平和LVEF为CHF患者贫血发生的独立影响因素。结论TNF-α参与了CHF患者心功能不全发生、发展的病理生理过程,并由此引发CHF贫血的发生,而CHF患者贫血的出现使心功能不全程度更加恶化。
Objective To study the change of hemoglobin（Hb） concentration and the relationship of Hb concentration with tumour necrosis factor-α（TNF-α） and cardiac function in patients with chronic heart failure （CHF）. Methods Hb concentration,serum level of TNF-α in 121 CHF patients were measured, and the left ventricular ejection fraction （LVEF） was determined by echocardiography. Then according to their Hb concentration, they were divided into two groups, CHF anemia group and CHF non-anemia group. Control group consisted of another 27 elderly healthy subjects. Results Hb concentration and LVEF in patients with CHF were lower than those in control subjects. With the increase of NYHA degree and development of disease, Hb concentration and LVEF significantly decreased, but the level of TNF-α was increased. The level of TNF-α in the anemia group of CHF patients was higher than that in the non-anemia group and control group. With the increase of anemia severity, the level of TNF-α significantly increased ,and it showed a positive correlation with Hb concentration （P 〈 0.01 ）, but a negative correlation with LVEF （P 〈 0.01 ）. Conclusions Increase of the level of TNF-α plays roles in the pathophysiological mechanism of CHF, leading to the development of anemia, and being correlated with the severity degree of CHF.
出处
《实用老年医学》
CAS
2007年第5期306-308,共3页
Practical Geriatrics
基金
青海省科技厅自然科学基金项目(2006-N-149)
关键词
慢性心力衰竭
贫血
肿瘤坏死因子-Α
chronic heart failure（CHF）
anemia
tumour necrosis factor-α（TNF-α）
