McMurray J, Abdullah I, Dargie H J, Shapiro D
Department of Cardiology, Western Infirmary, Glasgow.
Br Heart J. 1991 Nov;66(5):356-8. doi: 10.1136/hrt.66.5.356.
To ascertain whether patients with cardiac failure and reduced body weight ("cardiac cachexia") have increased circulating concentrations of tumour necrosis factor (cachectin).
Patients with cardiac failure were prospectively identified as "cachectic" (body fat less than 27% in men and less than 29% in women measured by skinfold thickness callipers) or "non-cachectic". Tumour necrosis factor was assayed blind to patient group.
Cardiology unit in a tertiary referral centre.
26 consecutive patients (10 women) (mean age 61) admitted for investigation or treatment of chronic heart failure. All were in New York Heart Association class III or IV.
In nine of the 16 cachectic patients the concentration of tumour necrosis factor was increased (mean (SEM) 74 (20) pg/ml) compared with one of the 10 "non-cachectic" patients (22 pg/ml, p less than 0.001). Patients with a raised circulating concentration of tumour necrosis factor weighed significantly less (55.6 (3.5) kg) than those in whom the concentration of tumour necrosis factor was normal (69.0 (4.1) kg) (p = 0.02).
Circulating concentrations of tumour necrosis factor were increased in a significant proportion of patients with chronic heart failure and low body weight. Tumour necrosis factor stimulates catabolism experimentally and it may be a factor in the weight loss seen in patients with "cardiac cachexia".
确定心力衰竭且体重减轻（“心源性恶病质”）的患者循环中肿瘤坏死因子（恶病质素）浓度是否升高。
前瞻性地将心力衰竭患者分为“恶病质组”（通过皮褶厚度卡尺测量，男性体脂低于27%，女性低于29%）或“非恶病质组”。对患者分组情况进行盲法检测肿瘤坏死因子。
一家三级转诊中心的心脏病科。
26例连续入院接受慢性心力衰竭检查或治疗的患者（10名女性）（平均年龄61岁）。所有患者均为纽约心脏协会心功能Ⅲ级或Ⅳ级。
16例恶病质患者中有9例肿瘤坏死因子浓度升高（平均（标准误）74（20）pg/ml），而10例“非恶病质”患者中仅有1例升高（22 pg/ml，p<0.001）。循环中肿瘤坏死因子浓度升高的患者体重（55.6（3.5）kg）明显低于肿瘤坏死因子浓度正常的患者（69.0（4.1）kg）（p = 0.02）。
相当一部分慢性心力衰竭且体重低的患者循环中肿瘤坏死因子浓度升高。肿瘤坏死因子在实验中可刺激分解代谢，可能是“心源性恶病质”患者体重减轻的一个因素。
