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肿瘤坏死因子-α受体1是急性心肌梗死患者死亡率及新发心衰的主要预测指标:心肌梗死患者的细胞因子激活及远期预后(c.ALPHA)研究

世界核心医学期刊文摘（心脏病学分册） 2005年第8期1卷 30-31页

作者： Valgimigli M. ceconi c. Malagutti P. 丁倩 Department of c.rdiology University of Ferrara Cardiovascular Institute A. S. Anna C.rso Giovecca 203 44100 Ferrara Italy

Bac.ground Tumor nec.osis fac.or alpha- α (TNF- α ) ac.ivation is an independent prognostic.indic.tor of mortality in patients with heart failure(HF). Despite the rec.gnition that several TNF family c.tokines are elevated during myoc.rdial infarc.ion, their role in predic.ing subsequent prognosis in these setting remains poorly understood. Methods and Results We performed a systematic.evaluation of TNF- α and its type 1 and 2 soluble rec.ptors, together with interleukin(IL)- 6, IL- 1 rec.ptor antagonist, and IL- 10, in 184 patients(132 men; mean age, 64± 12) c.nsec.tively admitted for myoc.rdial infarc.ion. We c.rrelated their values to short and long- term inc.denc. of death and HF(primary outc.me). In 10 patients, we also studied the presenc. of transc.rdiac.gradients for TNF- α and its soluble rec.ptors. The c.ntrol group c.mprised 45 healthy subjec.s who were sex and age matc.ed(33 men; mean age, 65± 6 years) to the patients. All tested c.tokines were inc.eased in patients, and no transc.rdiac.or systemic.AV differenc. was found. After a median follow- up of 406 days(range, 346 to 696 days), 24 patients died and 32 developed HF. Univariate analysis showed that all c.tokines were related to outc.me, whereas after adjustment for baseline and c.inic.l c.arac.eristic., sTNFR- 1 remained the only independent predic.or of death and HF(hazard ratio, 2.9; 95% c., 1.9 to 3.8, tertile 1 versus 3), together with left ventric.lar ejec.ion frac.ion, Killip c.ass, and c.eatine kinase- MB at peak. c.nc.usions sTNFR- 1 is a major short and long- term predic.or of mortality and HF in patients with ac.te myoc.rdial infarc.ion.

关键词：急性心肌梗死 c.ALPHA 细胞因子激活肿瘤坏死因子 α受体射血分数可溶性受体细胞因子水平白细胞介素受体拮抗剂

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