风湿性心脏病心房颤动患者血清肿瘤坏死因子的变化及其与心功能的关系

目的探讨血清肿瘤坏死因子(TNF-α)与风湿性心脏病心房颤动及心力衰竭的关系。方法170例风湿性心脏病患者分为心房颤动组86例和窦性心律组84例,检测2组患者血清TNF-α水平,并与对照组85例健康人相比较。结果心房颤动组患者的血清TNF-α水平显著高于窦性心律组和对照组(P<0.01),窦性心律组与对照组比较无明显差异(P>0.05)。心房颤动组和窦性心律组心功能Ⅱ级、Ⅲ级、Ⅳ级者TNF-α水平均高于心功能Ⅰ级者(P<0.05,P<0.01);心功能Ⅲ级、Ⅳ级者TNF-α水平均高于心功能Ⅱ级者(P<0.01);心功能Ⅳ级者TNF-α水平均高于心功能Ⅲ级者(P<0.05)。结论TNF-α水平与心房颤动的发生及心力衰竭的严重程度相关。

Level of serum tumor necrosis factor and the relationship with cardiac function in patients with rheu-matic heart disease complicated with atrial fibrillation

Objective To discuse the level of tumor necrosis factor（TNF-α） and the relationship with heart function in patients with rheumatic heart disease（RHD） complicated with atrial fibrillation. Methods One hundred and seventy patients with RHD were divided into atrial fibrillation（AF） group （eighty-six cases ）and sinus rhythm （SR） group （eighty-four cases ）, The serum level of TNF-α was detected respectively, and then compared with the control group（ eighty-five healthy people）. Resuits The serum level of TNF-α in AF group was significantly higher than that in SR group and control group（ P 〈 0.01 ）. There were no significant difference between SR group and control group （ P 〉 0.05 ）. The levels of TNF-α in patients with class Ⅱ , class Ⅲ and class Ⅳ of cardiac function in AF group and SR group were higher than that in patients with class Ⅰ of cardiac function（P 〈0.05 ,P 〈0.01 ）, the levels of TNF-α in patients with class Ⅲ and Ⅳ of cardiac function were higher than that in patients with class Ⅱ （ P 〈 0.01 ） ; the level of TNF-α in patients with class Ⅳ of cardiac function was higher than that in patients with class Ⅲ （ P 〈 O. 05 ）. Conclusion The level of TNF-α was associated with the incidence of atrial fibrillation and the degree of heart failure.