| Objective:To investigate the content and significance of plasma granu-locyte-macrophage colony-stimulating factor in CHF.Methods:1.41 patients (male:22, female:19) with heart failure admitted into the cardiological department of our hospital were enrolled. Average age was 66.8±9.1 (53-83) years.21 healthy subjects (male:9, female:12) from the Health examining center were chosen as the control group, with an average age of 60.6±9.5 (51-79) years. Exclusion criteria:cerebrovascular disease, serious infection, recent (<6 months) myocardial infarction, liver and renal dysfunction, cancer, thyroid disease, diabetes, blood and hematopoietic system diseases. Moreover, those with diseases that may cause elevation of myocardial injury markers recently (7 days) were also excluded, including acute coronary syndrome, acute heart failure, heart surgery, closed chest cardiac compression, defibrillation, direct current cardioversion.2. According to the etiology of heart failure, the subjects were divided into three groups:Rheumatic heart disease group (13cases), Dilated heart disease group (13cases) and Coronary heart disease group (15cases), there were no statistical significance among the there groups in age and sex (P >0.05). According to the criteria established by the American College of Cardiology/American Heart Association (ACC/AHA) in 2001, the subjects were divided into two groups:Stage C group and StageD group, considering the development of heart failure, there were no statistical significance among the two groups in age and sex (P>0.05). The content of GM-CSF in each group were determined.3. Each subject underwent tests of fasting periphery venous blood within 24 hours by ELISA, including FPG,TG,TC,LDL-C,HDL-C and Creat-ine. Those with abnormal indicators were excluded.Meanwhile,each subject were subtract extra 2 ml venous blood.After centrifugation,0.5ml clear su-pernatant liquid were deserved in-70℃,less than 6 months.GM-CSF conc-entration was measured by ELISA.4. Each subject underwent echocardiography. The diameters of LVED and LAD were measured by echocardiography. LVEF was determined by modified Simpson's method. Rheumatic heart disease and dilated heart disease met the corresponding diagnostic criteria.5. Statistical analysis were conducted with SPSS 16.0 software. Quanti-titive data were expressed as means±standard deviation.Comparisons betwe-en the control and the patients'group were examined by t-test.Comparisons among the three groups and the control group were examined by ANOVA. P<0.05 was considered statistically significant.Results:The serum level of GM-CSF in the CHF group was significan-tly higher than that in the control group (85.50±76.20 vs.26.05±8.55 pg/ml, P<0.05). The serum level of GM-CSF were 153.85±104.50 pg/ml in the rheumatic heart disease group,58.25±20.33 pg/ml in the dilated heart dise-ase group and 49.87±22.10 pg/ml in the coronary heart disease group.The serum level of GM-CSF in the rheumatic group was highest, comparing with the control group, the dilated heart disease and the CHD goup (P= 0.005, 0.036 and 0.021, respectively). There was no statistical significance betwe-en the dilated heart disease group and the coronary heart disease (P= 0.873, P> 0.05) group. Moreover, the serum level of GM-CSF was 53.91±22.22 pg/ml in CHF stage C group and was 121.47±99.01 pg/ml in CHF stage D group (P<0.05).Conclusion:1.The level of serum GM-CSF increased in chronic conge-stive heart failure. The level of serum GM-CSF have certain relations with degree of heart failure. It was suggested that GM-CSF might take part in the pathophysiological process of CHF.2.The level of serum GM-CSF varied with differrent causes. Rheumatic heart disease was significantly higher and results suggest that the level of serum GM-CSF may be related to immunologic injury.3.Measurement of blood granulocyte-macrophage colony-stimulating factor may be useful in the diagnosis as well as the degree of heart failure.
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