神经内分泌因子在扩张型心肌病心室重构及心力衰竭中的表达

目的：观察神经内分泌因子对扩张型心肌病（DCM）心室重构及心力衰竭的影响。方法：DCM患者120例，按心功能分级分为3组，心功能Ⅱ级组34例，心功能Ⅲ级组45例，心功能Ⅳ级组41例。另选取80例心功能正常者作为对照组。所有患者人院第2天均检测去甲肾上腺素（NE）、血管紧张素Ⅱ（AngⅡ）、细胞肿瘤坏死因-α（TNT-α）、白介素-6（IL-6）、细胞可溶性凋亡因子（sFas）。结果：DCM心功能Ⅱ～Ⅳ级患者与正常组对照，NE，AngⅡ、TNF-α、IL-6、sFas水平明显升高，且随着心功能恶化逐渐增强（P〈0．01）。DCM组中不同功能级别者与对照组相比差异有统计学意义（P〈0．05或P〈0．01〉。结论：DCM患者其NE，AngⅡ、TNF-α、IL-6、sFas常过度表达，通过影响心肌收缩力，引起心肌肥大，诱导心肌凋亡、纤维化，加重心室重构和心力衰竭发生、发展。

Neuroendocrine factor involved in the dilated cardiomyopathy patients with myocardial remodeling and congestive heart failure

Objective： To investigate the roles of norepinephrine （NE）, angiotensin Ⅱ （Ang Ⅱ ）, tumour necrosis factor α （TNF-α）, interleukin-6 （IL-6） and soluble Fas （sFas） in dilated cardiomyopathy （DCM） patients with myocardial remodeling and congestive heart failure. Methods： A total of 120 DCM patients with myocardial remodeling and congestive heart failure were divided into 3 groups according to functional classes： Thirty-five patients classified as classes Ⅱ of New York heart association （NYHA） group and 45 patients as classes Ⅲ group and 41 patients as classes Ⅳgroup. Another eighty persons with normal heart function were regard as control group. NE, Ang Ⅲ , TNF-α, IL-6 and sFas were detected on the second day of admission in all patients. Results： NE, AngⅢ , TNF-α, IL-6 and sFas were higher than those of control group and increased associated with the classes of CHF （P〈0.05 or P〈0.01）. Conclusion： NE, Ang Ⅱ , TNF-α, IL-6 and sFas are over-expressions and promote the initiation and development of DCM by influencing myocardium contractility and contributing to the myocardial remodeling process.