【摘要】 目的 :通过分析慢性心力衰竭 (HF)恶病质患者血清瘦素 (leptin)及肿瘤坏死因子α(TNF α)的浓度变化 ,探讨其在心源性恶病质发病过程中的可能作用及临床意义。方法 :测定 4 8例慢性HF患者和 2 0例健康对照者的体重指数 (BMI)、腰臀比 (WHR)、皮下脂肪厚度 (TSF)、左室射血分数 (LVEF)、leptin及TNF α等指标。leptin及TNF α用放射免疫法测定 ,并分析leptin与其他参数的相关性。结果 :①全部受试者的血清leptin浓度与BMI、TSF、TNF α呈显著正相关 (P <0 .0 5 ) ,与WHR及LVEF无显著相关性。而恶病质组的血清leptin浓度还与TNF α呈显著相关关系 (P <0 .0 5 )。②恶病质组与非恶病质组相比 ,BMI、leptin及TSF差异有显著性意义 ,均P <0 .0 1。结论 :leptin作为调节能量平衡的重要激素 ,可能与TNF α共同作用导致心源性恶病质的发生更多还原

【Abstract】 Objective:To explore the significance of leptin to the pathogenesis of cardiac cachexia according to alteration of serum leptin and TNF-α levels in chronic heart failure patients.Methods:Serum leptin and TNF-α concentration were measured by radioimmunoassay. Body mass index (BMI), waist to hip ratio (WHR), triceps skin-fold thickness (TSF), left ventricular ejection fraction (LVEF) were determined in 48 patients with chronic heart failure and in 20 health controls. The correlation between leptin and other parameters was analysed.Results:①Only LVEF and TNF-α had significant difference between NC group and CHF group (P< 0.05), Serum leptin concentration in all 68 subjects were significantly correlated with BMI, TSF (P< 0.05), but no relation with other parameters, however, in cachetic group serum leptin concentration have significant correlation with TNF-α (P< 0.05). ② To compare cachectic with non-cachectic group, BMI, leptin and TSF had significant diffrence, respectly (P< 0.01).Conclusion:As a important hormone with regulation of energy balance, the effect of leptin and TNF-α together result in cardiac cachexia state.更多还原