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目的:探讨血浆一氧化氮(NO)、内皮素-1(ET-1)和肿瘤坏死因子-α(TNF-α)在充血性心力衰竭 (CHF)病程中的临床意义。方法:将58例CHF患者根据NYHA分级标准分为Ⅱ级、Ⅲ级及Ⅳ级,采用放射免疫法和比色法分别检测58例CHF者和20例健康者血浆NO、ET-1和TNF-α浓度。结果:CHF组血浆NO、ET- 1和TNF-α含量明显高于正常对照组(均P<0．05),CHF组血浆ET-1的增幅大于NO,NO/ET比值下降,且上述改变与CHF严重程度有关(P<0．05),NO与ET间呈显著正相关。结论:血浆NO、ET-1及TNF-α浓度增高,NO/ET比值降低是心力衰竭病理生理特征之一,反映了心力衰竭时血管内皮系统的功能紊乱。
Objective: To investigate the clinical significance of plasma nitric oxide (NO), endothelin-1 (ET-1) and tumor necrosis factor-α (TNF-α) in the course of congestive heart failure (CHF). Methods: Fifty-eight CHF patients were divided into grade Ⅱ, grade Ⅲ and grade Ⅳ according to the NYHA classification criteria. The levels of plasma NO, ET-1 and TNF-α in 58 CHF patients and 20 healthy controls were detected by radioimmunoassay and colorimetry, respectively. α concentration. Results: The plasma levels of NO, ET-1 and TNF-α in CHF group were significantly higher than those in normal control group (all P <0.05). The levels of ET-1 in CHF group were higher than those in NO group and the NO / ET ratio decreased And CHF severity (P <0.05), NO and ET showed a significant positive correlation. CONCLUSIONS: Increased concentrations of NO, ET-1 and TNF-α in plasma, and decreased NO / ET ratio are one of the pathophysiological features of heart failure, reflecting the dysfunction of vascular endothelial system during heart failure.