Zhao S P, Zeng L H
Department of Cardiology, Second Affiliated Hospital, Hunan Medical University, Changsha, People's Republic of China.
Int J Cardiol. 1997 Feb;58(3):257-61. doi: 10.1016/s0167-5273(96)02873-2.
To study the potential role of tumor necrosis factor (TNF) in chronic heart failure, we measured the plasma levels of TNF by enzyme linked immunoabsorbent assay in 109 patients with various heart diseases grouped as 'non-heart failure' (n = 36), 'heart failure' (n = 36) and 'cachectic' (n = 37). The daily food intake was also investigated. The results showed that there was no obvious difference of daily caloric intake among the three groups of patients. Plasma levels of TNF were significantly elevated in the patients with 'heart failure' (0.51 +/- 0.26 ng/ml, mean +/- S.E.M.), and even higher in the patients with 'cachexia' (6.19 +/- 2.76 ng/ml), as compared with the patients with 'non-heart failure' (0.09 +/- 0.03 ng/ml). Twenty-five patients with 'cachexia' and 11 patients with 'heart failure' had plasma levels of TNF > or = 100 pg/ml, whereas only 5 patients with 'non-heart failure' had plasma levels of TNF above that level. The patients with high levels of TNF were more cachectic than those with normal levels of TNF (body mass index 19.5 +/- 3.4 vs. 22.3 +/- 3.6, P < 0.05). In multivariate analysis, elevated levels of TNF were associated with the level of serum total protein, presence of heart failure and cachexia. These findings indicate that plasma levels of TNF are increased in patients with heart failure, and high levels of TNF may play an important role in the pathogenesis of cardiac cachexia.
为研究肿瘤坏死因子（TNF）在慢性心力衰竭中的潜在作用，我们采用酶联免疫吸附测定法检测了109例患有各种心脏病的患者的血浆TNF水平，这些患者被分为“非心力衰竭”组（n = 36）、“心力衰竭”组（n = 36）和“恶病质”组（n = 37）。同时还调查了患者的每日食物摄入量。结果显示，三组患者的每日热量摄入无明显差异。与“非心力衰竭”患者（0.09 +/- 0.03 ng/ml）相比，“心力衰竭”患者的血浆TNF水平显著升高（0.51 +/- 0.26 ng/ml，均值 +/- 标准误），“恶病质”患者的血浆TNF水平更高（6.19 +/- 2.76 ng/ml）。25例“恶病质”患者和11例“心力衰竭”患者的血浆TNF水平大于或等于100 pg/ml，而“非心力衰竭”患者中只有5例血浆TNF水平高于该值。TNF水平高的患者比TNF水平正常的患者更消瘦（体重指数分别为19.5 +/- 3.4和22.3 +/- 3.6，P < 0.05）。多因素分析显示，TNF水平升高与血清总蛋白水平、心力衰竭及恶病质的存在相关。这些发现表明，心力衰竭患者的血浆TNF水平升高，高水平的TNF可能在心脏恶病质的发病机制中起重要作用。
