The Clinical Research On Relationship Of ET-1、TNF-a And COPD With Pulmonary Heart Disease

Objective:By detecting the levels of tumor necrosis factor-a (Tumor Necrosis Factor-a, TNF-a), endothelin-1(Endothelin-1, ET-1) in patients with chronic obstructive pulmonary disease (Chronic obstructive pulmonary disease, COPD) with pulmonary endogenous heart disease, To investigate its role in the pathogenesis of pulmonary heart disease.Methods:30eligible COPD with pulmonary heart disease patients from Dept of Pulmonology, the Second Affiliated Hospital of Nanchang University, Including20males and10females;30patients with COPD, Consists of18men and12women;30Physical examination person in the same period in the second affiliated hospital of nanchang university medical department, including20males and10females; All subjects underwent echocardiography examination, mainly to detect pulmonary artery pressure, By enzyme-linked immunosorbent assay (EILSA) determinate the serum ET-1, TNF-a levels in Pulmonary heart disease patients, pulmonary heart disease and COPD group both accept cardiac echocardiography、pulmonary function, arterial blood gas analysis, compared With COPD group and healthy control group, conduct the correlation analvsis of the detection indicators.Results:(1) Compared with COPD patients and control group, the serum ET-1, TNF-a are Significantly increased in COPD patients with pulmonary heart disease, the differences are all statistically significant (p<0.05); The level of serum ET-1, TNF-a in COPD group is higher than the control group, the difference is statistically significant (P<0.05);(2) Compared with COPD patients, FEV1percentage of predicted value%, PaO2of cor pulmonale group are significantly decreased, the differences are all statistically significant (p<0.05)(3) Compared with the group of COPD pulmonary artery pressure, pulmonary heart disease group are significantly elevated pulmonary artery pressure, the difference is statistically significant (P<0.05);the serum ET-1levels of are positively correlated with pulmonary arterial pressure pulmonary heart disease patients(r=0.38, P<0.01); the serum TNF-a levels are positively correlated with pulmonary arterial pressure (r=0.23,P<0.01)Conclusions:(1) The serum ET-1levels of cor pulmonale group are higher than the serum ET-1levels in COPD and control group, and the serum ET-1levels of cor pulmonale group is positively correlated with pulmonary artery pressure, suggesting that ET-1may related with COPD with pulmonary heart disease occurrence and development.(2) The serum TNF-a levels of cor pulmonale group are higher than the serum TNF-a levels in patients of COPD and control group, the serum ET-1levels of cor pulmonale group is positively correlated with pulmonary artery pressure, suggesting that TNF-a may be associated with pulmonary hypertension, TNF-a may be related with the development and progression of pulmonary heart disease.