不同心功能分级慢性心力衰竭患者血清BNP、TNF-α、MMP-9、IL-6检测的临床价值探讨

摘要

Objective To discuss the clinical value of serum brain natriuretic peptide (BNP) ,tumor necrosis factor‐α(TNF‐α) , matrix metalloproteinase‐9(MMP‐9) and interleukin‐6(IL‐6) detection in chronic heart failure (CHF) patients with different heart function grades and their correlation with CHF .Methods Totally 67 cases of CHF in our hospital from Jan .2013 to Jun .2015 were selected as the observation group and the NYHA classification was performed :gradeⅠ in 15 cases ,gradeⅡ in 21 cases ,gradeⅢ in 23 cases and grade Ⅳ in 9 cases .Other 30 individuals undergoing the healthy physical examination were chosen as the control group at the same period .The venous blood samples were collected for detecting serum BNP ,TNF‐α,MMP‐9 and IL‐6 .LVEDD ,LVESD and LVEF were measured by echocardiography .Then the obtained data were analyzed by using the SPSS 21 .0 software .Results The serum BNP ,TNF‐α,MMP‐9 and IL‐6 levels in the observation group and various cardiac function groups were higher ,the differences between them were statistically significant (P< 0 .05);LVEF in the observation group and various cardiac function groups were obviously declined ,while LVEDD and LVESD were obviously increased ,the differences were statistically significant (P<0 .05) .The linear regression was adopted to analyze the correlation between serum BNP ,TNF‐α,MMP‐9 and IL‐6 with the left ventricular echocardiographic parameters in the CHF patients ,the results showed that serum BNP ,TNF‐α,MMP‐9 and IL‐6 levels were negatively correlated with LVEF (P<0 .05) ,while positively correlated with LVEDD and LVESD (P<0 .05) .Conclusion The serum BNP ,TNF‐α,MMP‐9 and IL‐6 levels are the good indexes for diagnosing CHF ,moreover can accurately reflect different heart function status in the CHF patients with different cardiac function grades ,which are closely related to the occurrence and de‐velopment process of CHF .%目的：探讨不同心功能分级慢性心力衰竭（CHF）患者血清脑钠肽（BNP）、肿瘤坏死因子‐α（TNF‐α）、基质金属蛋白酶‐9（MMP‐9）、白细胞介素‐6（IL‐6）检测的临床价值，并探讨与CHF之间的相关性。方法选择2013年1月至2015年6月在该院就诊的CHF患者67例作为观察组并进行N Y H A分级：Ⅰ级15例、Ⅱ级21例、Ⅲ级23例、Ⅳ级9例，另选同期30例健康体检者作为对照组，均静脉采血且分别测定其血清BNP、TNF‐α、MMP‐9、IL‐6，通过超声心动图检查分别测定其 LVEF、LVEDD、LVESD ，对所得数据采用SPSS 21．0统计学软件进行分析。结果观察组、各心功能组血清BNP、TNF‐α、MMP‐9、IL‐6水平明显较高，两组相比较差异均有统计学意义（P＜0．05），观察组、各心功能组LVEF明显下降，LVEDD、LVESD明显升高，两组比较差异均有统计学意义（P＜0．05），采用线性回归分析CHF患者血清BNP、TNF‐α、MMP‐9及IL‐6与左心室超声心动图参数之间的相关性，结果表明 CHF患者血清BNP、TNF‐α、MMP‐9以及 IL‐6水平分别与 LVEF呈负相关（均 P＜0．05），而与 LVEDD、LVESD呈正相关（均 P＜0．05）。结论血清BNP、TNF‐α、MMP‐9、IL‐6水平是诊断CHF的良好指标，且可以准确地反映不同心功能分级CHF患者的心脏功能状态，与CHF的发生、发展过程关系密切。