Th1型细胞因子干扰素γ及Th2型细胞因子白细胞介素10水平在慢性心力衰竭患者接受己酮可可碱干预过程中的变化:随机对照  

Changes in the levels of Th1 type cytokine interferon-gamma and Th2 type cytokine interleukin-10 after Pentoxifylline therapy for patients with chronic heart failure:A randomized controlled trial

作　　者：万建平[1] 卢永昕[1] 徐玉兰[1] 刘向阳[2] 

机构地区：[1]华中科技大学同济医学院附属协和医院心血管病研究所,湖北省武汉市430022 [2]韶关市粤北医院心内科,广东省韶关市512000

出　　处：《中国组织工程研究与临床康复》2007年第45期9079-9082,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:观察己酮可可碱治疗心力衰竭患者后Th1型细胞因子干扰素γ及Th2型细胞因子白细胞介素10水平的变化,评价己酮可可碱对慢性心力衰竭患者免疫异常调节作用。方法:选择2005-09/2006-04华中科技大学同济医学院附属协和医院心内科收治的心力衰竭患者38例。①实验分组:随机分为常规治疗组20例,常规治疗包括利尿剂,洋地黄类药物,血管紧张素转换酶抑制剂,β-受体阻滞剂等。己酮可可碱治疗组18例,在常规治疗的基础上加用己酮可可碱400mg,3次/d,饭时口服。两组治疗时间为1周,且均禁用免疫抑制剂。另选取10例健康体检者作为健康对照组。②实验评估:采用流式细胞分析法对各组患者进行CD4+Th1型细胞因子干扰素γ和Th2型细胞因子白细胞介素10水平进行检测,从而测出相应Th1,Th2细胞的百分比。结果:参与常规治疗组实验患者均进入结果分析,参与己酮可可碱治疗组患者18例,脱落3例,余15例患者均进入结果分析。①慢性心力衰竭患者CD4+干扰素γ表达水平和Th1/Th2值高于健康对照组(P<0.05),CD4+白细胞介素10表达水平低于健康对照组(P<0.05)。②己酮可可碱治疗组治疗1周后,CD4+干扰素γ水平和Th1/Th2值低于常规治疗组(P<0.05)。CD4+白细胞介素10水平无显著性变化。结论:心力衰竭患者存在Th1/Th2失衡,己酮可可碱调节了慢性心力衰竭患者Th1/Th2的失衡,该效应可能是己酮可可碱改善慢性心力衰竭患者症状作用机制之一。AIM： To observe the changes of interferon-γ （IFN-γ） of Thl type cytokine and interleukin-10 （IL-10） of Th2 type cytokine in patients with chronic heart failure treated with Pentoxifylline, and evaluate the regulatory effect of Pentoxifylline （PTX） on immunologic abnormality in patients with heart failure. METHODS： Thirty-eight patients with heart failure were selected from Department of Cardiology, Union Hospital, Tongji Medical College of Huazhong University of Science and Technology between September 2005 and April 2006. ①They were randomly divided into routine therapy group （n =20, including diuretic, digitaloid drugs, angiotensin-concerting enzyme inhibitor, and β-blocker） and PTX therapy group （n =18） with 400 mg PTX besides the routine therapy, 3 times daily, orally taken in dinner. Both groups were treated for 1 week with no immunosuppressive agent. Meanwhile, 10 healthy volunteers were selected as control group. ②IFN-γ and IL-10 levels were determined by flow cytometry to measure the percentages of Thl and Th2 cells. RESULTS： All patients of routine therapy group were involved in the result analysis, and only 15 of PTX group entered the analysis with 3 loss. ①The level of CD4＋ IFN-γ and ratio of Thl/Th2 in patients with chronic heart failure were significantly higher than those of control group （P 〈 0.05）, but CD4^＋ IL10 levels were lower than those of control group （P 〈 0.05）. ②After the treatment of PTX for 1 week, the level of CD4^＋ IFN-γ and ratio of Th1/Th2 were significantly lower than those of control group （P 〈 0.05）. But no obvious changes were found in IL-10 levels. CONCLUSION： There is a Th1/Th2 cytokine imbalance in patients with chronic heart failure. PTX can regulate the polarization of Th1/Th2, which may be one of the mechanisms to improve the symptoms in chronic heart failure.

关 键 词：心力衰竭 己酮可可碱 TH细胞 广谱免疫凋节 

分 类 号：R392.114[医药卫生—免疫学]