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TNF-α水平对急性心肌梗死预后的影响 (PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2004年第1期
页码:
39-40
栏目:
临床研究
出版日期:
2004-01-01

文章信息/Info

Title:
The influence of elevated TNF-α levels on prognosis after AMI
作者:
潘晓明; 吴宗贵; 黄佐; 任雨笙; 何松青; 朱立新
上海长征医院心内科,上海 200003
Author(s):
PAN Xiao-ming;  WU Zong-gui;  HUANG Zuo;  REN Yu-sheng;  HE Song-qing;  ZHU Li-xin
Department of Cardiology, Changzheng Hospital, Shanghai 200003, China
关键词:
心肌梗塞; 急性;  肿瘤坏死因子-α;  预后
Keywords:
myocardial infarction;  acute;  tumor necrosis factor-α;  prognosis
分类号:
R542.22
DOI:
-
文献标识码:
A
摘要:
目的:观察急性心肌梗死(AMI)病情稳定后肿瘤坏死因子(TNF-α)水平升高对AMI预后的影响。方法:选1998-08～2001-01的 AMI患者134例,随访3～32个月,将随访期内发生心绞痛、再次心肌梗死、心力衰竭及死亡的患者34例作为事件组,同时,在随访期内未发生冠心病事件的患者中选取与事件组年龄、性别配对的患者34例作为对照组,排除肝肾功能不全及存在明确的炎症病变者。AMI患者发病后4～8周抽静脉血加入 EDTA后分离血浆,用 ELISA法检测血浆中 TNF-α含量。同时检测 CRP及 SAA。结果:两组患者一般临床情况比较,事件组有糖尿病者多于对照组(P>0.05);其余临床情况无显著差异。事件组血浆TNF-α及 CRP水平均高于对照组(P<0.05),而SAA水平两组间无显著差异。结论:AMI后血浆TNF-α及CRP水平持续升高患者可能提示其具有较高的冠心病事件发生率,应加强对此类患者的二级预防。
Abstract:
AIM: To observe the influence of persistent elevated tumor necrosis factor-α(TNF-α) level on prognosis of patients who have recovered from acute myocardial infarction(AMI). METHODS: 327 case of initial AMI were followed up for 3～32 months, 34 patients occured angia,reinfarction, heart failure and cardiac death during follow-up and another 34 age- and sex-matched patiens who free of recurrent coronary events were selected as case group and control group, respectively, Those who had definite liver or renal dysfunction,inflammative diseases were discarded. Plasma TNF-α was tested by ELISA, CRP and SAA were tested simultaneously within AMI ocuured 24 h, after AMI ocuured 4～8 weeks, respectively. RESULTS: In contrast to control group, levels of palsma TNF-α and CRP were higher (P<0.05) in case group; level of palasma SAA was no significant difference(P >0.05) between two groups. CONCLUSION: Patients whose levels of plasma TNF-αand CRP were elevated persistently after AMI might imply morbidity of recurrent coronary events, and should emphase second prevention to these patients.

参考文献/References

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[2] Hegeisch S, Wen HJ, HossfeldDK. TNF-induced cardiomyopathy[J]. Lancet,1990,2:294-295.

[3]Irwin MW,Mak S,Mann DL,et al. Tissue expression and immunoocalization of tumor necrosis factor-α in postinfarctin dysfunctional myocardium[J].Circulation,1999,99:1492-1498.

[4]Ridker PM,Rifai N,Pfeffer M,et al.Elevation of tumor necrosis factor-α and increased risk of recurrent coronary events after myocardial infarction[J]. Circulation,2000,101:2149-2153.

[5]王晓明,李源,李慧芳,等.心力衰竭患者血清中TNF-α,IL-1及IL-6的变化及培哚普利对其的影响[J].心脏杂志,2002,14(4):318-322.

备注/Memo

备注/Memo:
收稿日期：2003-1-30
更新日期/Last Update: 2004-01-01