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摘要目的：探讨老年慢性心力衰竭（CHF）肿瘤坏死因子琢（TNF-α）以及脑利钠肽水平的变化，并对其进行相关性分析。方法：选择老年CHF患者59 例，根据心功能分级，Ⅱ级19 例，Ⅲ级25 例，Ⅳ级15 例；另选心功能正常的老年人36例。所有入选者予以血清BNP、TNF-α测定，并采用彩色多普勒超声测定左心室舒张末内径并计算左室射血分数（LVEF）。结果：与对照组比较，CHF组心功能Ⅲ、Ⅳ级患者TNα-琢水平明显升高（P＜0.05），心功能Ⅱ、Ⅲ、Ⅳ级患者血BNP水平明显升高（P＜0.05），并随心功能分级加重而增加。血TNF-α水平与BNP 呈正相关（r=0.57，P＜0.05）。CHF患者中血清TNF-α和BNP 水平与LVEF比较均呈负相关（r=-0.48, r=-0.64, P＜0.05）。结论：老年CHF患者血TNF-α显著升高，并与BNP及LVEF关系密切，是反应CHF患者心功能恶化的重要预测指标。

英文摘要:

ABSTRACT Objective:To investigate the change of tumor necrosis factor alpha (TNF-α) and brain natriuretic peptide (BNP) level in elderly patients with chronic heart failure (CHF), and to investigate their correlation. Methods:59 elderly patients with CHF were selected, according to the classification of cardiac function, 19 cases of grade II, 25 cases of grade Ⅲ , 15 cases of grade Ⅳ ; 36 normal elderly subjects were selected as the control group. The detection of BNP and TNF-αwas performed on all subjects, and the determination of left ventricular end-diastolic diameter and left ventricular ejection fraction (LVEF) by color Doppler ultrasound was also investigated. Results:Compared with the control group, the concentration of TNF-αin CHF group with cardiac function on grade III and IV increased significantly (P<0.05), the concentration of BNP in CHF group with cardiac function on grade Ⅱ , Ⅲ and Ⅳ increased significantly (P<0.05), and both increased with the increase of cardiac function classification. Serum TNF-αlevel was positively correlated with BNP (r=0.57, P<0.05). In patients with CHF, serum TNF-αand BNP levels were negatively correlated with LVEF (r=-0.48, r=-0.64, P<0.05).Conclusion: The serum TNF-αof elderly patients with CHF increased significantly, and showed relationship with BNP and LVEF, it is an important predict of deterioration of cardiac function in patients with CHF.

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