【摘要】 目的:观察神经内分泌因子对扩张型心肌病(DCM)心室重构及心力衰竭的影响。方法:DCM患者120例,按心功能分级分为3组,心功能Ⅱ级组34例,心功能Ⅲ级组45例,心功能Ⅳ级组41例。另选取80例心功能正常者作为对照组。所有患者入院第2天均检测去甲肾上腺素(NE)、血管紧张素Ⅱ(AngⅡ)、细胞肿瘤坏死因-α(TNT-α)、白介素-6(IL-6)、细胞可溶性凋亡因子(sFas)。结果:DCM心功能Ⅱ～Ⅳ级患者与正常组对照,NE,AngⅡ、TNF-α、IL-6、sFas水平明显升高,且随着心功能恶化逐渐增强(P<0.01)。DCM组中不同功能级别者与对照组相比差异有统计学意义(P<0.05或P<0.01〉。结论:DCM患者其NE,AngⅡ、TNF-α、IL-6、sFas常过度表达,通过影响心肌收缩力,引起心肌肥大,诱导心肌凋亡、纤维化,加重心室重构和心力衰竭发生、发展。更多还原

【Abstract】 Objective:To investigate the roles of norepinephrine(NE),angiotensinⅡ (AngⅡ),tumour necrosis factorα(TNF-α),interleukin-6(IL-6) and soluble Fas(sFas) in dilated cardiomyopathy(DCM) patients with myocardial remodeling and congestive heart failure.Methods:A total of 120 DCM patients with myocardial remodeling and congestive heart failure were divided into 3 groups according to functional classes:Thirty-five patients classified as classes Ⅱ of New York heart association(NYHA) group and 45 patients as classes Ⅲ group and 41 patients as classes Ⅳ group.Another eighty persons with normal heart function were regard as control group.NE,AngⅡ,TNF-α,IL-6 and sFas were detected on the second day of admission in all patients.Results:NE,AngⅡ,TNF-α,IL-6 and sFas were higher than those of control group and increased associated with the classes of CHF(P<0.05 or P<0.01).Conclusion:NE,AngⅡ,TNF-α,IL-6 and sFas are over-expressions and promote the initiation and development of DCM by influencing myocardium contractility and contributing to the myocardial remodeling process.更多还原