老年慢性左心衰患者多种生物标记物变化及临床意义

摘要

Objective To investigate the clinical significance αof multiple biomarkers in elderly with chronic left heart failure (LHF). Methods A total of 86 elderly patients with chronic left ventricular failure whose heart function were from NYHA Ⅰ to NYHA Ⅳ. CD34+ cells, tumor necrosis factor-α (TNF-α), sTNFR-1, sTNFR-2, VEGF, Toll-like receptors (TLR2 、TLR4) and LVEF were measured, and compared to those of normal controls. Results Compared to normal subjects, the levels of CD34+ cells on elderly patients with LHF were elevated in the early stage and decreased with advanced heart function stage. TNF-α, sTNFR-1, sTNFR-2, VEGF, TLR2 and TLR4 were increase(P＜0.05 or ＜0.01). Cardiac function and LVEF of patients were inversely associated with TNF-α, sTNFR-1, sTNFR-2, VEGF, TLR2, TLR4( all P ＜ 0. 01 ). Conclusions The levels of TNF-α, sTNFR-1, sTNFR-2, VEGF, TLR2 and TLR4 were significanfiy higher in elderly patients with chronic LHF, and the changes of aboved factors may be associated with generation, progress and the graveness degree of LHF.%目的 探讨老年慢性左心衰(LHF)患者多种生物标记物变化的临床意义.方法 选择86例心功能Ⅰ～Ⅳ级的老年慢性LHF患者,检测其CD34 +细胞、TNF-α、可溶性肿瘤坏死因子受体-1(sTNFR-1)、sTNFR-2、血管内皮生长因子(VEGF)、Toll样受体(TLR2、TLR4)及左室射血分数(LVEF),并与正常对照者比较.结果 与正常人比较,LHF患者早期CD34 +细胞升高、随着心功能级别增加而明显下降,TNF-α、sTNFR-1、sTNFR-2、VEGF、TLR2和TLR4明显升高(P＜0.05或＜0.01);患者的心功能及LVEF均与TNF-α、sTNFR-1、sTNFR-2、VEGF、TLR2、TLR4呈负相关(P均＜0.01).结论 老年慢性LHF患者TNF-α、sTNFR-1、sTNFR-2、VEGF、TLR2和TLR4明显升高,上述指标变化可能与LHF的发生、发展及其严重程度有关.