慢性心衰急性发作期炎性细胞因子变化的临床意义  

A Study on Level of Proinflammatory Cytokine in Patients with Acute Exacerbations of Chronical Heart Failure

作　　者：陆永光[1] 文宏[1] 曲楠[1] 黎东华[1] 陈艺钊[1] 

机构地区：[1]广西医科大学第一附属医院心内科广西心血管病研究所,广西南宁530021

出　　处：《辽宁中医杂志》2010年第5期875-877,共3页Liaoning Journal of Traditional Chinese Medicine

摘　　要：目的:评价慢性心衰急性发作患者血浆炎性细胞因子肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平变化的临床意义。方法:选取2007年2月—2008年1月入住我院的因各种原因导致的慢性心衰急性发作患者60例,入院后在抗心衰治疗前以及治疗后3天和7天时,测定血浆炎性细胞因子TNF-α、IL-6水平,出院后随访12个月,记录患者发生主要心血管事件的情况。另选正常对照20例.测定血浆炎性细胞因子TNF-α、IL-6水平。结果:慢性心衰急性发作患者血浆炎性细胞因子TNF-α、IL-6明显高于正常对照组,差异有统计学意义(P<0.05);与入院时比较,治疗后第3天和第7天血浆炎性细胞因子TNF-α、IL-6水平均明显下降(P<0.05),且治疗后两个时相间差异有统计学意义(P<0.05);与随访期间非事件组比较,事件组血浆TNF-α、IL-6水平在各时间点均较高(P<0.05)。结论:慢性心衰急性发作期炎性细胞因子TNF-α、IL-6的监测对患者病情严重程度的评估、治疗效果及远期预后有一定临床意义。Objective：To explore the clinica1 correlation between changes of plasma proinflammatory cytokines level and the treatment and prognosisin of patients with acute episode of chronical heart failure（CHF）.Methods：Left ventricular diameters and left ventricular rejection fractions were measured by echocardiography and dynamic changes plasma proinflammatory cytokines TNF- and IL-6 levels were tested by enzyme linked immunoadsorbent assay in 60 patients with acute exacerbations of CHF and 20 healthy control subjects before treatment and 3,7 days after the treatment.The patients were follow up for one year and the major adverse cardiac events were recorded.Results：The levels of TNF-α and IL-6 in patients with acute episode of CHF were markedly increased comparing to sham group（P0.05）.Compared with the level before treatment,the levels of TNF-α and IL-6 were markedly lower 3 and 7 days after treatment（P0.05）.There were differencese 3d time point and 7d time point（P0.05）.The levels of TNF-α and IL-6 were higher at all times in patients with the major adverse cardiac events than without the events（P0.05）.Conclusion：During acute exacerbations of CHF,higher levels of plasma TNF-α and IL-6 may have certain values for diagnosis,assessing the sever degree of CHF and predicting long term prognosis in patients with chronic heart failure.

关 键 词：慢性心力衰竭 急性发作 炎性细胞因子 

分 类 号：R541.6[医药卫生—心血管疾病]