充血性心力衰竭患者血清炎性反应因子检测的临床意义

目的探讨充血性心力衰竭（CHF）患者血清炎性反应因子的变化及临床意义。方法采用放射免疫分析法分别测定110例CHF患者（CHF组）和60例健康体检者（健康对照组）白细胞介素-6（IL-6）及肿瘤坏死因子-α（TNF-α）水平，同时采用胶乳增强免疫透射比浊法检测两组患者的血清C反应蛋白（CRP）水平。检测CHF组治疗后上述3种血清炎性反应因子水平，并与治疗前相比较。结果CHF组血清IL-6、TNF-α和CRP水平明显高于健康对照组，且随心功能分级增加依次增高，差异有统计学意义（P〈0．01）。CHF组患者左室射血分数（LVEF）与血清IL-6（r=0．585，P〈0．01）、TNF-α（r=0．312，P〈0．01）和CRP（r=0．458，P〈0．01）水平呈显著正相关。与治疗前相比，治疗后CHF组患者LVEF较治疗前明显增加，而血清IL-6、TNF-α和CRP水平明显下降，差异有统计学意义，均P〈0．01（t=12．144，9．835，7．847，4．616）。结论血清炎性反应因子IL-6、TNF-α和CRP检测有助于CHF患者的病情评估、疗效监测和预后判断。

Clinical significance of measurement of serum inflammatory factors in patients with congestive heart failure

Objective To investigate the change of serum inflammatory factors in patients with congestive heart failure （CHF） and its clinical significance. Methods Radioimmunoassay was employed to measure the serum levels of inflammatory factors including interleukin-6 （IL-6） and tumor necrosis factor-alpha （TNF-α） in 110 CHF patients （CHF group） and 60 healthy controls （control group）, and latex-enhanced immunoturbidimetric assay was used for the measurement of serum C-reactive protein （CRP）. And the levels of above 3 kind cytokines were measured after treatment in CHF group, as compared with those before treatment. Results The serum levles of IL-6, TNF-α and CRP were markedly higher in CHF group than those of control group, and they increased gradually along with increasing cardiac functional grading （P〈0.01）. In CHF group, left ventricular ejection fraction （LVEF） was directly related to IL-6 （r=0.585,P〈0.01） and TNF-α（r=0.312,P〈0.01） as well as CRP （r=0.458,P〈0.01）. After treatment, LVEF of CHF group was markedly elevated, while the serum levles of IL-6, TNF-α and CRP were substantially reduced as compared with those before treatment （t=12. 144, 9. 835, 7. 847 and 4. 616 respectively; all P〈0.01）. Conclusion Measurement of the serum levels of inflammatory factors contributes to appraisal of pathogenetic condition, monitoring of therapeutic effect and evaluation of prognosis in CHF patients.