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目的:研究慢性心力衰竭(CHF)患者血红蛋白(Hb)、血清肿瘤坏死因子(TNF)-α和血管紧张素Ⅱ(AngⅡ)水平的变化及其之间的关系。方法:对入选的121例CHF患者(CHF组)和27例正常人(对照组)(均海拔2260m)测定了Hb、血清TNF-α和AngⅡ水平,超声心动图测量左室射血分数(LVEF),按Hb水平将CHF患者分为贫血组和非贫血组。结果:CHF患者Hb水平降低,而血清TNF-α和AngⅡ水平增高,与对照组比较均差异有统计学意义(均P<0.01);随着心功能恶化,Hb水平逐渐降低,而血清TNF-α和AngⅡ水平逐渐升高;贫血组患者血清TNF-α和AngⅡ水平明显增高,与非贫血组比较均差异有统计学意义(均P<0.01);随着Hb水平降低,CHF患者血清TNF-α和AngⅡ水平逐渐升高;CHF患者Hb水平与TNF-α和AngⅡ水平呈负相关(P<0.01)。结论:CHF患者Hb水平降低、TNF-α和AngⅡ水平的升高与CHF恶化有关,Hb水平与TNF-α和AngⅡ水平呈负相关。
Objective: To study the changes of hemoglobin (Hb), serum tumor necrosis factor (TNF) -α and angiotensin Ⅱ (AngⅡ) in patients with chronic heart failure (CHF) and their relationship. Methods: The levels of Hb, serum TNF-α and AngⅡ were measured in 121 CHF patients (CHF group) and 27 healthy controls (control group) at an altitude of 2260 m. Echocardiography was used to measure left ventricular ejection fraction (LVEF ), According to Hb level CHF patients were divided into anemia group and non-anemia group. Results: The levels of Hb in CHF patients were decreased, while the levels of TNF-α and AngⅡ in serum were higher than those in control group (all P <0.01). Hb levels decreased gradually with the deterioration of cardiac function, (P <0.01). With the decrease of Hb level, the level of serum TNF-α and AngⅡ in patients with anemia was significantly higher than that in non-anemia patients (all P <0.01) α and AngⅡ gradually increased. Hb levels in CHF patients were negatively correlated with TNF-αand AngⅡ (P <0.01). CONCLUSIONS: The Hb level in CHF patients is decreased. The elevated levels of TNF-α and AngⅡ are associated with the deterioration of CHF. The levels of Hb are negatively correlated with the levels of TNF-α and AngⅡ.