血浆BNP、TNF-α、sTWEAK水平变化与心力衰竭的相关性分析
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摘要
目的探讨血浆B型脑钠肽(BNP)、肿瘤坏死因子-α(TNF-α)、人肿瘤坏死因子样弱凋亡诱导因子(sTWEAK)在慢性心力衰竭患者中的变化及其临床意义。方法选取我院确诊的120例慢性心力衰竭患者(心衰组),收治时间2014年1月-2017年5月,选取60例健康人群作为对照组,检测两组的血浆BNP、TNF-α、sTWEAK水平,按照纽约心功能分级进行亚组分析,探讨血浆BNP、TNF-α、sTWEAK水平变化与患者心功能指标的相关性。结果心衰组患者血浆BNP、TNF-α高于对照组(P<0.05),血浆sTWEAK低于对照组(P<0.05);Ⅱ级、Ⅲ级、Ⅳ级心衰组患者血浆BNP、TNF-α、sTWEAK组间比较差异均具有统计学意义(P<0.05),并且依次血浆BNP、TNF-α呈逐渐升高,sTWEAK依次呈逐渐降低的趋势(P<0.05);心衰患者的血浆BNP与患者LVEF呈显著的负相关关系(P<0.05)、与患者的LVEDd呈显著的正相关关系(P<0.05);心衰患者的血浆sTWEAK与患者LVEF呈显著的正相关关系(P<0.05)、与患者的LVEDd呈显著的负相关关系(P<0.05)。结论心衰患者的血浆BNP、TNF-α升高、sTWEAK降低显著,并且与患者心功能变化关系密切。
Objective To investigate the changes and clinical significance of plasma type B brain natriuretic peptide(BNP),tumor necrosis factor alpha(TNF-)and human tumor necrosis factor like weak apoptosis inducing factor(sTWEAK)in patients with chronic heart failure.Methods A total of 120 patients with chronic heart failure patients in our hospital diagnosed(heart failure group),from January 2014 to May 2017,a total of 60 cases of healthy subjects as the control group,the levels of plasma BNP and TNF-of the two groups,the level of sTWEAK alpha,subgroup analysis was done according to the New York classification of cardiac function,to explore the correlation between plasma BNP,TNF-alpha,sTWEAK level patients with cardiac function index.Results Heart failure patients plasma BNP,TNF-were higher than that of the control group(P<0.05),plasma sTWEAK in patients with heart failure was lower than that of the control group(P<0.05);II,III and IV heart failure patients plasma BNP,TNF-alpha,sTWEAK difference between groups were statistically significant(P<0.05),patients with different heart function classification plasma BNP,TNF-alpha was gradually increased,sTWEAK was decreased(P<0.05);patients with heart failure and plasma BNP in patients with LVEF showed a significant negative correlation(P<0.05),there was a significant positive correlation between BNP and LVEDd in patients with heart failure(P<0.05);patients with heart failure patients with plasma sTWEAK LVEF was a significant positive correlation(P<0.05),there was a significant negative correlation between sTWEAK and LVEDd in patients with heart failure patients(P<0.05).Conclusion patients with heart failure,the levels of BNP,TNF-and sTWEAK decreased significantly,and were closely related to the changes of cardiac function in patients with heart failure.
Objective To investigate the changes and clinical significance of plasma type B brain natriuretic peptide(BNP),tumor necrosis factor alpha(TNF-)and human tumor necrosis factor like weak apoptosis inducing factor(sTWEAK)in patients with chronic heart failure.Methods A total of 120 patients with chronic heart failure patients in our hospital diagnosed(heart failure group),from January 2014 to May 2017,a total of 60 cases of healthy subjects as the control group,the levels of plasma BNP and TNF-of the two groups,the level of sTWEAK alpha,subgroup analysis was done according to the New York classification of cardiac function,to explore the correlation between plasma BNP,TNF-alpha,sTWEAK level patients with cardiac function index.Results Heart failure patients plasma BNP,TNF-were higher than that of the control group(P<0.05),plasma sTWEAK in patients with heart failure was lower than that of the control group(P<0.05);II,III and IV heart failure patients plasma BNP,TNF-alpha,sTWEAK difference between groups were statistically significant(P<0.05),patients with different heart function classification plasma BNP,TNF-alpha was gradually increased,sTWEAK was decreased(P<0.05);patients with heart failure and plasma BNP in patients with LVEF showed a significant negative correlation(P<0.05),there was a significant positive correlation between BNP and LVEDd in patients with heart failure(P<0.05);patients with heart failure patients with plasma sTWEAK LVEF was a significant positive correlation(P<0.05),there was a significant negative correlation between sTWEAK and LVEDd in patients with heart failure patients(P<0.05).Conclusion patients with heart failure,the levels of BNP,TNF-and sTWEAK decreased significantly,and were closely related to the changes of cardiac function in patients with heart failure.
引文
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[14]毛治尉,王平,郭攀,等.心力衰竭患者医院感染特点与病原菌分析[J].中华医院感染学杂志,2015,34(12):2769.
[15]韩思梁,刘素云,张瑞宁.慢性心力衰竭患者血浆CTRP5水平变化[J].山东医药,2017,57(22):47.
[2]王贤方,张园,李锐,等.重组人肿瘤坏死因子相关弱凋亡诱导因子对小鼠主动脉内皮舒张功能及凝血相关因子的影响[J].中国动脉硬化杂志,2014,22(1):22.
[3]鲁航,孙元水.肿瘤坏死因子样弱凋亡诱导因子在胃癌患者中的表达及其与营养状况的关系[J].中华胃肠外科杂志,2016,19(10):1165.
[4]崔志远,曹慧,庞晓.慢性心力衰竭患者血清肿瘤坏死因子α水平变化及其与心肾功能的关系[J].山东医药,2016,56(17):66.
[5]Stancheva N,Tisheva S,Kurkchiev S,et al.629N‐terminal pro brain natriuretic peptide and tumor necrosis factor alpha and outcome in patients with heart failure with reduced vs.preserved systolic function[J].European Journal of Heart Failure Supplements,2015,5(S1):147.
[6]任满意,张小娟.肿瘤坏死因子样凋亡微弱诱导剂在心脏重塑及其相关疾病中作用的研究进展[J].中国循环杂志,2014,29(3):238.
[7]Huang K,Duan N,Zou W,et al.Fused hydrophobic elastin-likepeptides(ELP)enhance biological activity of tumor necrosis factor-related apoptosis-inducing ligand(TRAIL)[J].Protein&Peptide Letters,2015,22(11):1000.
[8]刘韵,张园,洪长江,等.重组人脑利钠肽治疗急性心力衰竭的效果及对肿瘤坏死因子样弱凋亡诱导物的影响[J].广东医学,2015,25(14):2154.
[9]Marti C N,Khan H,Mann D L,et al.Soluble tumor necrosis factor receptors and heart failure risk in older adults:Health,Aging,and Body Composition(Health ABC)Study[J].Circulation Heart Failure,2014,7(1):5.
[10]孟丹,曹雪滨.肿瘤坏死因子-α在心力衰竭及其治疗中的研究进展[J].中华危重病急救医学,2015,27(12):1022.
[11]Marti C N,Khan H,Mann D L,et al.Soluble tumor necrosis factor receptors and heart failure risk in older adults:Health,Aging,and Body Composition(Health ABC)Study[J].Circulation Heart Failure,2014,7(1):5.
[12]Ronsisvalle N,Di B G,Parenti C,et al.CHF5074protects SHSY5Yhuman neuronal-like cells from amyloidbeta 25-35and tumor necrosis factor related apoptosis inducing ligand toxicity in vitro.[J].Current Alzheimer Research,2014,11(7):714.
[13]许宗磊,司明文,冯桂青,等.心力衰竭患者肺部感染血浆脑钠肽与炎性因子的变化分析[J].中华医院感染学杂志,2015,35(2):250.
[14]毛治尉,王平,郭攀,等.心力衰竭患者医院感染特点与病原菌分析[J].中华医院感染学杂志,2015,34(12):2769.
[15]韩思梁,刘素云,张瑞宁.慢性心力衰竭患者血浆CTRP5水平变化[J].山东医药,2017,57(22):47.