血清胎盘生长因子在慢性心力衰竭患者中的应用效果

魏引　何亚磊　蔡叶锐　周季　张鑫　常业飞

[摘要] 目的 研究血清胎盘生长因子（PlGF）在慢性心力衰竭患者中的应用效果，为临床相关诊治提供参考。 方法 选取2015年1～3月云南省第三人民医院（以下简称“我院”）收治的慢性心力衰竭患者85例作为观察组，同期选取我院参加健康体检的60名健康者作为对照组。采用酶联免疫吸附法（ELISA法）检测两组患者PlGF、高敏C-反应蛋白（hs-CRP）及肿瘤坏死因子-α（TNF-α）含量，各心功能分级血清指标含量，并对观察组患者进行对症治疗，其后再比较各血清指标变化。 结果 观察组治疗前血清PlGF、hs-CRP及TNF-α含量均高于对照组，差异均有统计学意义（P < 0.05）;随着患者心功能分级增高，其血清PlGF、hs-CRP及TNF-α含量均升高，差异均有统计学意义（P < 0.05）;观察组治疗后血清PlGF、hs-CRP及TNF-α含量低于治疗前，差异均有统计学意义（P < 0.05）。 结论 慢性心力衰竭患者血清PlGF、hs-CRP及TNF-α含量均较健康者升高，且随着心功能分级增高而上升，经对症治疗，可有效改善患者上述指标，为临床诊治提供重要参考。

[关键词] 血清胎盘生长因子;高敏 C-反应蛋白;肿瘤坏死因子-α;慢性心力衰竭

[中图分类号] R541.6          [文献标识码] A          [文章編号] 1673-7210（2019）06（b）-0039-04

Application effect of serum placental growth factor in patients with chronic heart failure

WEI Yin   HE Yalei   CAI Yerui   ZHOU Ji   ZHANG Xin   CHANG Yefei

Department of Cardiology， the Third People′s Hospital of Yunnan Province， Yunnan Province， Kunming   650000， China

[Abstract] Objective To study the effect of serum placental growth factor （PlGF） in patients with chronic heart failure， and to provide reference for clinical diagnosis and treatment. Methods Eighty-five patients with chronic heart failure admitted to the Third People′s Hospital of Yunnan Province （“our hospital” for short） from January to March 2015 were selected as the observation group， and 60 healthy patients who participated in the physical examination in our hospital were selected as the control group. Enzyme-linked immunosorbent assay （ELISA） was used to detect the levels of PlGF， hs-CRP and TNF-α in the two groups. The serum indexes of each cardiac function grade were measured. The patients in the observation group were treated symptomatically， and then the changes of serum indexes were compared. Results The serum levels of PlGF， hs-CRP and TNF-α in the observation group were higher than those in the control group before treatment， and the differences were statistically significant （P < 0.05）. The serum levels of PlGF， hs-CRP and TNF-α in the observation group increased with the increase of cardiac function grade， and the differences were statistically significant （P < 0.05）. The serum levels of PlGF， hs-CRP and TNF-α in the observation group after treatment were lower than those before treatment， and the differences were statistically significant （P < 0.05）. Conclusion The serum levels of PlGF， hs-CRP and TNF-α in patients with chronic heart failure are higher than those in healthy people， and increase with the increase of cardiac function grade. Symptomatic treatment can effectively improve the above-mentioned indicators of patients and provide important reference for clinical diagnosis and treatment.

综上所述，慢性心力衰竭患者血清PlGF、hs-CRP及TNF-α含量均较健康者升高，且随着心功能分级增高而升高，经对症治疗，可有效改善患者上述指标，可为临床诊治提供重要参考。

[参考文献]

[1]  Gandhi PU，Szymonifka J，Motiwala SR，et al. Characterization and prediction of adverse events from intensive chronic heart failure management and effect on quality of life：results from the pro-B-type natriuretic peptide outpatient-tailored chronic heart failure therapy（PROTECT）study [J]. J Card Fail，2015，21（1）：9-15.

[2]  Zile MR，Baicu CF，Ikonomidis JS，et al. Myocardial Stiffness in Patients With Heart Failure and a Preserved Ejection Fraction：Contributions of Collagen and Titin [J]. Circulation，2015，131（14）：1247-1259.

[3]  Ponikowski P，van Veldhuisen DJ，Comincolet J，et al. Beneficial effects of long-term intravenous iron therapy with ferric carboxymaltose in patients with symptomatic heart failure and iron deficiency [J]. Eur Heart J，2015，36（11）：657-668.

[4]  Takei M，Kataoka M，Yanagisawa R，et al. Parallel Running Two-way Right Ventricles as a Cause of Refractory Right Heart Failure [J]. Heart Lung Circ，2016，25（10）：143-144.

[5]  Rostagno C，Galanti G，Comeglio M，et al. Comparison of different methods of functional evaluation in patients with chronic heart failure [J]. Eur J Heart Fail，2014，2（3）：273-280.

[6]  中華医学会心血管病学分会，中华心血管杂志编辑委员会.慢性心力衰竭诊断治疗指南[J].中华心血管杂志，2007，35（12）：32-44.

[7]  Cardinale M，Altshuler J，Testani JM. Efficacy of Intravenous Chlorothiazide for Refractory Acute Decompensated Heart Failure Unresponsive to Adjunct Metolazone [J]. Pharmacotherapy，2016，36（8）：843.

[8]  Pose A，Almenar L，Gavira JJ，et al. Benefit of tolvaptan in the management of hyponatraemia in patients with diuretic-refractory congestive heart failure：the SEMI-SEC project [J]. Esc Heart Fail，2017，4（2）：130-137.

[9]  Chernomordik F，Freimark D，Arad M，et al. Quality of life and long-term mortality in patients with advanced chronic heart failure treated with intermittent low-dose intravenous inotropes in an outpatient setting [J]. Esc Heart Fail，2017，4（2）：122-129.

[10]  Brown JL，Estep JD. Temporary Percutaneous Mechanical Circulatory Support in Advanced Heart Failure [J]. Heart Fail Clin，2016，12（3）：385.

[11]  Hasegawa T，Tabata H，Kagoshima M，et al. A case of pregnancy-associated acute myocardial infarction with refractory ventricular fibrillation and heart failure [J]. J Card Cases，2016，14（1）：13-16.

[12]  Salaun E，Pankert M，Habib G，et al. How should I treat refractory cardiogenic shock in a patient with chronic biventricular heart failure and mitral regurgitation with difficult valve characteristics [J]. J Euroint，2016，11（10）：1201-1206.

[13]  Sur A，Manraj H，Lavoie PM，et al. Multiple Successful Angioembolizations for Refractory Cardiac Failure in a Preterm with Rapidly Involuting Congenital Hemangioma [J]. Ajp Reports，2016，6（1）：99.

[14]  Yoon PJ，An JN，Hyun JJ，et al. Early initiation of continuous renal replacement therapy improves survival of elderly patients with acute kidney injury：a multicenter prospective cohort study[J].Crit Care，2016，20（1）：260.

[15]  Truche AS，Darmon M，Bailly S，et al. Erratum to：Continuous renal replacement therapy versus intermittent hemodialysis in intensive care patients：impact on mortality and renal recovery [J]. Inten Care Med，2016，42（9）：1408.

[16]  Delgado JF，Conde E，Sánchez V，et al. Pulmonary vascular remodeling in pulmonary hypertension due to chronic heart failure [J]. Eur J Heart Fail，2014，7（6）：1011-1016.

[17]  Wang X，Chen JB，Liang XH. Clinical effect of continuous renal replacement therapy（CRRT）combined with Bi PAP noninvasive ventilation in the treatment of refractory end-stage heart failure [J]. Hainan Med J，2015，31（80）：51-79.

[18]  Pan Y，Lu Z，Hang J，et al. Effects of Low-Dose Recombinant Human Brain Natriuretic Peptide on Anterior Myocardial Infarction Complicated by Cardiogenic Shock [J]. Brazilian J Card Surg，2017，32（2）：96-103.

[19]  Wang Y，Gu X，Fan W，et al. Effects of recombinant human brain natriuretic peptide on renal function in patients with acute heart failure following myocardial infarction [J]. Ame J Trans Res，2016，8（1）：239.

[20]  Wu C，Wang X，Yu W，et al. Short-term consequences of continuous renal replacement therapy on body composition and metabolic status in sepsis [J]. Asia Pacific J Clin Nutri，2016，25（2）：300.

[21]  Ostermann M，Joannidis M，Pani A，et al. Patient Selection and Timing of Continuous Renal Replacement Therapy [J]. Blood Pur，2016，42（3）：224.