CAJ | 학술논문

目的：探讨肿瘤坏死因子-α（TNF-α）、可溶性肿瘤坏死因子受体-1（sTNFR-1）和可溶性肿瘤坏死因子受体-2（sTNFR-2）水平对老年陈旧性心肌梗死严重程度的影响。方法选择2010年1月至2014年3月徐州医学院附属淮安医院老年病科老年陈旧性心肌梗死患者140例，并按照冠状动脉病变支数、美国纽约心脏病学会（NYHA）分级和左心室射血分数（LVEF）高低进行分组。采用酶联免疫吸附测定（ELISA）法检测TNF-α、sTNFR-1和sTNFR-2水平变化。结果随着老年陈旧性心肌梗死严重程度的加重，TNF-α、sTNFR-1和sTNFR-2水平显著升高。冠状动脉单支病变组TNF-α（30．3±11．3）ng／L、sTNFR-1（590．2±50．9）ng／L、sTNFR-2（706．4±91．7）ng／L与冠状动脉四支病变组TNF-α（69．8±10．7）ng／L、sTNFR-1（3929．6±1001．3）ng／L、sTNFR-2（4016．8±1007．4）ng／L组间两两比较，差异有统计学意义（P＜0．05）；NYHAⅠ级组 TNF-α（28．7±10．1）ng／L、sTNFR-1（600．3±49．8）ng／L、sTNFR-2（711．7±82．6）ng／L 与 NYHA Ⅳ级组 TNF-α（78．5±14．6）ng／L、sTNFR-1（3825．4±991．8）ng／L％、sTNFR-2（4214．6±1073．9）ng／L组间两两比较，差异有统计学意义（P＜0．05）；LVEF 48％～58％组 TNF-α（20．0±8．6）ng／L、sTNFR-1（300．1±25．4）ng／L、sTNFR-2（299．3±49．9）ng／L）与 LVEF 25％～35％组 TNF-α（59．9±11．2）ng／L、sTNFR-1（3778．6±1001．9）ng／L、sTNFR-2（3624．6±1103．9）ng／L组间两两比较，差异有统计学意义（P＜0．05）。结论TNF-α、sTNFR-1和sTNFR-2水平的变化可能预测老年陈旧性心肌梗死的严重程度。
목적：탐토종류배사인자-α（TNF-α）、가용성종류배사인자수체-1（sTNFR-1）화가용성종류배사인자수체-2（sTNFR-2）수평대노년진구성심기경사엄중정도적영향。방법선택2010년1월지2014년3월서주의학원부속회안의원노년병과노년진구성심기경사환자140례，병안조관상동맥병변지수、미국뉴약심장병학회（NYHA）분급화좌심실사혈분수（LVEF）고저진행분조。채용매련면역흡부측정（ELISA）법검측TNF-α、sTNFR-1화sTNFR-2수평변화。결과수착노년진구성심기경사엄중정도적가중，TNF-α、sTNFR-1화sTNFR-2수평현저승고。관상동맥단지병변조TNF-α（30．3±11．3）ng／L、sTNFR-1（590．2±50．9）ng／L、sTNFR-2（706．4±91．7）ng／L여관상동맥사지병변조TNF-α（69．8±10．7）ng／L、sTNFR-1（3929．6±1001．3）ng／L、sTNFR-2（4016．8±1007．4）ng／L조간량량비교，차이유통계학의의（P＜0．05）；NYHAⅠ급조 TNF-α（28．7±10．1）ng／L、sTNFR-1（600．3±49．8）ng／L、sTNFR-2（711．7±82．6）ng／L 여 NYHA Ⅳ급조 TNF-α（78．5±14．6）ng／L、sTNFR-1（3825．4±991．8）ng／L％、sTNFR-2（4214．6±1073．9）ng／L조간량량비교，차이유통계학의의（P＜0．05）；LVEF 48％～58％조 TNF-α（20．0±8．6）ng／L、sTNFR-1（300．1±25．4）ng／L、sTNFR-2（299．3±49．9）ng／L）여 LVEF 25％～35％조 TNF-α（59．9±11．2）ng／L、sTNFR-1（3778．6±1001．9）ng／L、sTNFR-2（3624．6±1103．9）ng／L조간량량비교，차이유통계학의의（P＜0．05）。결론TNF-α、sTNFR-1화sTNFR-2수평적변화가능예측노년진구성심기경사적엄중정도。
Objective To study the levels of circulating tumor necrosis factor-α(TNF-α)、soluble tumor necrosis factor receptor-1 (sTNFR-1 )and soluble tumor necrosis factor receptor-2 (sTNFR-2 )in elderly patients with various degrees old myocardial infarction.Methods Elderly patients (n=140)were recruited from the Affiliated Huaian Hospital of Xuzhou Medical College and divided into three groups according to vessel diseases、NYHA and LVEF.Serum levels of TNF-α、sTNFR-1 and sTNFR-2 in patients <br> with various degrees old myocardial infarction and control group (n=50)were measured by nephelometry immunoassay.Results The levels of TNF-α、sTNFR-1 and sTNFR-2 was elevated in elderly patients with old myocardial infarction.In patients with old myocardial infarction.TNF-α(30.3 ±11.3)ng/L、sTNFR-1 (590.2 ±50.9)ng/L、sTNFR-2 (706.4 ±91.7)ng/L in single vessel disease group vs TNF-α(69.8 ± 10.7)ng/L、sTNFR-1 (3929.6 ±1001.3)ng/L、sTNFR-2 (4016.8 ±1007.4)ng/L in four vessel disease group,compared between these two groups,all P<0.05;NYHAⅠ group TNF-α(28.7 ±10.1 )ng/L、sTNFR-1 (600.3 ±49.8)ng/L、sTNFR-2 (711.7 ±82.6)ng/L vs NYHA Ⅳ group TNF-α(78.5 ± 14.6)ng/L、sTNFR-1 (3825.4 ±991.8)ng/L、sTNFR-2 (4214.6 ±1073.9)ng/L,compared between these two groups,all P<0.05;LVEF 48%-58% group TNF-α(20.0 ±8.6)ng/L、sTNFR-1 (300.1 ± 25.4)ng/L、sTNFR-2 (299.3 ±49.9)ng/L vs LVEF 25%-35% group TNF-α(59.9 ±11.2)ng/L、sTNFR-1 (3778.6 ±1001.9)ng/L、sTNFR-2 (3624.6 ±1103.9)ng/L,compared between these two groups,all P<0.05.Conclusions Changes in circulation TNF-α、sTNFR-1 and sTNFR-2 in elderly patients with old myocardial infarction maybe become the new indicators to forecast the degree of old myocardial infarction.