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目的探讨缺血性心肌病(ICM)患者血红蛋白水平、细胞因子、神经内分泌激素及心功能变化的相关性。方法测定入选121例慢性充血性心力衰竭(CHF)患者的血红蛋白(Hb)水平、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和血管紧张素Ⅱ(AngⅡ)的变化;超声心动图测量左室射血分数(LVEF),评价心功能;按Hb水平分为ICM贫血组和非贫血组,同时选择27例正常人作为对照组。结果ICM贫血组TNF-α、IL-6和AngⅡ水平明显高于非贫血组,而LVEF显著低于非贫血组(P<0.01);随着TNF-α、IL-6和AngⅡ水平升高,Hb和LVEF明显降低(P<0.01);ICM患者Hb水平和LVEF与TNF-α、IL-6和AngⅡ水平呈负相关,Hb水平与LVEF呈正相关(P<0.01)。结论ICM患者神经内分泌激素和细胞因子激活影响并促进贫血与心力衰竭的病理生理过程。
Objective To investigate the correlation between hemoglobin level, cytokines, neuroendocrine hormones and cardiac function in patients with ischemic cardiomyopathy (ICM). Methods The levels of hemoglobin, TNF-α, IL-6 and AngⅡ in 121 patients with chronic congestive heart failure (CHF) The left ventricular ejection fraction (LVEF) was measured by echocardiography and the cardiac function was evaluated. Hb level was divided into ICM anemia group and non-anemia group, and 27 normal subjects were selected as control group. Results The levels of TNF-α, IL-6 and AngⅡ in ICM anemia group were significantly higher than those in non-anemia group, but LVEF was significantly lower than that in non-anemia group (P <0.01) Hb and LVEF were significantly decreased (P <0.01). Hb level and LVEF in ICM patients were negatively correlated with TNF-α, IL-6 and AngⅡ levels, and Hb levels were positively correlated with LVEF (P <0.01). Conclusion ICM patients with neuroendocrine hormones and cytokines activation and promote anemia and heart failure pathophysiology.