肿瘤坏死因子对原发性高血压左室构型的影响

目的：探讨肿瘤坏死因子（TNF）在原发性高血压心肌肥厚过程中的病理生理作用。方法：原发性高血压病人64制，对照组30例，以超声心动图测定左心室质量指数（LVMI）和室壁相对厚度（RWT）．根据LVMI与RWT把高血压组分成四种构型。用发光免疫法测定血清TNF含量．结果：高血压组TNF寺量正著高于正常对照组，并且与血压升高程度呈正相关；2．正常构型组TNF含量显著高于正常对照组；3．向心性重构组及向心性肥厚组显著高于正常构型组．但两组之间的差别不显著；4．离心性肥厚组TNF显著高于其他构型组；5．TNF与LVMI、左室舒张期末容积（EDV）及收缩期末容积（ESV）正相关，与左心室射血分数（EF）负相关。结论：TNF促进了左室构型向离心性肥厚的发展．

THE EFFECT OF TUMOR NECROSIS FACTOR ON LEFT VENTRICULAR PATTERN IN PATIENTS WITH PRIMARY HYPERTENSION

Objective: To investigate the pathophysiological mechanism of tumor necrosis factor(TNF) on primary hypertension hypertrophy. Methods: The left ventricular mass index(LVMI) and relative wall thickness(RWT) were determined by echocardiography in 64 primary hypertension patients and 30 normal control subjects.The patients with hypertension were divided into 4 different left ventricular geometric patterns and were analyzed according to LVMI and RWT.The blood serum TNF was determined by light-immunoassay at the same time.Results: 1.The level of TNF was greatly increased in all patients when compared with that of normal controls,which had a parallel relationship with the raising in hypertension.2.The level of TNF in normal left ventricular group was significantly higher than that of normal controls.3.The levels of TNF in concentric remolding and typical concentric hypertrophy group were significantly higher than that of normal left ventricular group.But the difference between them was not significant.4.The level of TNF in eccentric left ventricular group was significantly higher than that of other groups.5.TNF had a parallel relationship with LVMI,end-diastolic volume(EDV) and end-systolic volume(ESV),but a negative relationship with left ventricular ejection fraction(EF).Conclusion: TNF may play an promoting role in eccentric left ventricular hypertrophy.