充血性心力衰竭患者血清细胞因子与心功能的关系及阿托伐他汀的干预作用  

Effects of atorvastatin on cardiac function and serum levels of tumor necrosis factor-α and interleukin-6 in patients with congestive heart failure

作　　者：黄亚辉[1] 张桂霞[1] 张朝雷[1] 王环宇[1] 

机构地区：[1]佳木斯市中心医院心内科,黑龙江佳木斯154002

出　　处：《心血管康复医学杂志》2010年第4期376-379,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨充血性心力衰竭(CHF)患者血清肿瘤坏死因子(TNF)-α和白细胞介素(IL)-6水平的变化与心功能的关系及阿托伐他汀对其水平的影响。方法:84例CHF患者被随机分为阿托伐他汀治疗组(42例)和常规治疗组(42例),另选30例健康人作为正常对照组,采用放射免疫方法检测各组治疗前后血清中TNF-α及IL-6的水平,并作心脏超声检查,评估心功能。结果:①84例心功能I^IV级CHF患者血清中TNF-α水平:[(0.52±0.16)μg/L∶(0.64±0.17)μg/L∶(0.79±0.17)μg/L∶(0.88±0.18)μg/L],IL-6[(96.67±17.79)μg/L∶(119.19±25.48)μg/L∶(143.51±26.63)μg/L∶(154.21±23.39)μg/L]随着心功能损害程度加重而显著升高(P<0.05);②阿托伐他汀组与常规治疗组治疗后血清TNF-α,IL-6水平均较治疗前明显下降(P<均0.05),且阿托伐他汀组较常规治疗组治疗后血清中TNF-α[(0.63±0.21)μg/L∶(0.74±0.19)μg/L],IL-6[(108.87±20.86)μg/L∶(113.92±15.37)μg/L]降低更明显(P<0.05);③治疗后阿伐他汀治疗组左室射血分数[(40±6)%∶(36±5)%]、左室收缩末容积指数[(31±6)ml/m2∶(34±5)ml/m2]、左室舒张末容积指数[(47±12)ml/m2∶(51±11)ml/m2]较常规治疗组明显改善(P均<0.05)。结论:①充血性心力衰竭患者TNF-,αIL-6水平与心功能状态密切相关;②阿托伐他汀能降低血浆细胞因子(肿瘤坏死因子、白细胞介素-6)水平,改善心脏功能,有益于慢性心力衰竭的治疗。Objective： To investigate the effects of atorvastatin on cardiac function and serum levels of tumor necrosis factor-α （TNF-α） and interleukin-6 （IL-6） in patients with congestive heart failure （CHF）. Methods： The levels of serum TNF-α and IL-6 were determined by radioimmunoassay in 84 CHF cases [42 of whom were treated by atorvastatin （atorvastatin group） and other 42 were treated by routine treatment （routine therapy group）]. The 30 health cases were regard as normal control group. Before and after treatment, the heart function was evaluated by echocardiogram. Results.. （1） The levels of TNF-α and IL-6 in all 84 CHF cases were much higher than those of normal control group （P〈0.01） ; and follow with the cardiac function decreased （NYHA Ⅰ -Ⅳ class） serum TNF-α level [ （0.52±0.16）μg/L vs. （0.64±0.17） μg/L vs. （0.79±0.17） μg/L vs. （0.88±0.18） μg/L], IL-6 level [（96. 67±17. 79）μg/L vs. （119.19±25.48） μg/L vs. （143.51±26. 63） μg/L vs. （154.21±23.39） μg/L] significantly increased （P〈0. 05） ; （2） The levels of TNF-α and IL-6 after treatment in both atorvastatin group and routine therapy group significantly decreased （P〈0.05）, but compared with routine therapy group, the TNF-α levels [ （0.74±0. 19） μg/L vs. （0.63±0.21） μg/L], IL-6 level [ （113.92±15.37） μg/L vs. 108.87±20. 85） μg/L] in atorvastatin group decrease more significant （P〈0.05） ; （3） The heart function index： LVEF [ （40±6）% vs. （ 36±5）%], LVESVI [ （31±6） ml/m^2 vs. （34±5） ml/m^2], LVEDV [ （47±12） ml/m^2 vs. （51±11） ml/m^2] in therapy group significantly improved compared with routine therapy group （P〈0.05） ; （4） A significantly correlation positive was found among the serum TNF-a and IL-6. Conclusion： （1） Contents of TNF-α, IL-6 have close re- lationship with the heart function of CHF; （2） Short-term atorvastatin improves cardiac function, reduces levels of serum c

关 键 词：阿托伐他汀 心力衰竭 充血性 肿瘤坏死因子Α 白细胞介素6 

分 类 号：R259.416.1[医药卫生—中西医结合]