慢性心力衰竭患者促炎性和抗炎性细胞因子的变化及临床干预研究  

Changes of inflammation-promoting and anti-inflammatory cytokines and study of clinical intervention in patients with chronic heart failure

作　　者：何国平[1] 沈丽娟[1] 戚传平[1] 肖建强[1] 徐波[1] 顾君[1] 杨国英[1] 

机构地区：[1]江苏大学附属武进医院心内科,常州213002

出　　处：《中华老年心脑血管病杂志》2008年第11期834-836,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨慢性心力衰竭（CHF）患者炎性细胞因子变化对心功能的影响及临床干预后的效果。方法选择100例CHF患者（心衰组）及50例无心脏病的健康体检者（对照组），取静脉血6ml，采用CBA蛋白分析系统检测白细胞介素－8（IL－8）、TNF－α、白细胞介素－10（IL－10）水平，并做心脏超声检测。心衰组中随机选择68例分为西拉普利组和常规治疗组治疗，两组分别25例和20例完成随访12周。治疗12周时检测血清IL－8、IL－10和TNF－α水平及心脏超声。结果心衰组患者血清中IL－8、TNF－α、IL－10水平均明显高于对照组（P〈0．01）；IL－8、TNF－α及IL－10三者间互呈正相关（P〈0．05）；IL－8／IL－10及TNF－α及IL－10比值随CHF的加重而升高（P〈0．05）；西拉昔利组治疗后较治疗前血清IL－8、TNF－α水平显著下降（P〈0．05），IL－10水平呈上升趋势，心脏超声除左心室舒张末期内径外，各项指标均有显著改善；常规治疗组治疗后较治疗前仅LVEF和缩短分数有所改善，细胞因子水平无显著变化。结论CHF时各种炎性细胞因子分泌异常，抗炎性细胞治疗有望成为治疗CHF的新方法。Objective To explore the influence of serum concentrations of interleukin-8 （IL-8）, TNF-α and interleukin 10 （IL-10）on heart function, and the efficacy of clinical intervention in patients with congestive heart failure （CHF）. Methods 100 patients with CHF （CHF group） and 50 healthy physical examinees（control group） were selected. The serum levels of IL-8,IL 10 and TNF-α were measured with CBA protein assay system. Patients with CHF were divided randomly into cilazapril group and conventional treatment group and followed up for 12 weeks. Results The main findings in the CHF group were as follows： The serum levels of IL-8,10 and TNF were significantly higher than those in the control group （P d0.01） ;The serum levels of IL-8,10 and TNF-α were positively correlated to each other; The ratios of IL 8/IL-10 and TNF-α/IL-10 increased with increasing the severity of CHF （P〈0.05） ; The serum levels of IL-8 and TNF-α were significantly decreased, and the serum level of IL-10 showed a rising trend after treatment as compared with before treatment in the cilazapril group;The LVEF, fractional shortening（FS） and CO were significantly increased in the cilazapril group, but in the control group, only LVEF and FS were improved,while cytokine levels showed no change. Conclusion The cytokines were out of balance in the patients with CHF. These disorders were related to the abnormal secretion of inflammatory cytokines and treatment with anti inflammatory cytokines is expected to be a new treatment for CHF.

关 键 词：心力衰竭 充血性 白细胞介素8 白细胞介素10 肿瘤坏死因子 

分 类 号：R541.6[医药卫生—心血管疾病]