摘要
目的研究充血性心力衰竭(CHF)患者血清肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)和转化生长因子β1(TGF-β1)的水平,以及抗心力衰竭治疗前后上述细胞因子水平的变化,探讨细胞因子和心功能的关系。方法选择56例CHF患者和30例健康体检者,按美国纽约心脏病协会(NYHA)标准对CHF患者进行心功能分级。56例CHF患者入院后均常规给予洋地黄制剂、血管紧张素转换酶抑制剂(ACEI)、β受体阻滞剂和利尿剂等治疗。TNF-α、IL-6、TGF-β1采用ELISA方法检测,CHF患者于入院第2天和抗心力衰竭治疗15d后空腹采血,健康体检者清晨空腹采血。应用彩色多普勒超声心动图测定治疗前后CHF患者和健康体检者的左室射血分数(LVEF),分析心功能改变与细胞因子的相关性。结果CHF患者血清TNF-α、IL-6、TGF-β1较对照组明显升高(P<0.05或P<0.01),其水平随心功能恶化而升高,尤其在心功能Ⅳ级组升高最明显。CHF患者血清TNF-α、IL-6、TGF-β1与LVEF呈显著负相关(r1=-0.58,r2=-0.61,r3=-0.59,P均<0.01)。不同病因CHF患者TNF-α、IL-6、TGF-β1水平差异无统计学意义(P均>0.05)。结论CHF患者血清TNF-α、IL-6、TGF-β1水平与心功能密切相关,与CHF病因无关。TNF-α、IL-6及TGF-β1可以作为判断CHF患者病情轻重、治疗效果和预后的独立预测因子。
Objective To study changes of serum TNF-α, IL-6 and TGF-β1 in patients with congestive heart failure （CHF） and explore relations between the above cytokines and cardiac function. Methods Fifty-six patients with CHF and 30 healthy subjects were selected. Cardiac function was classified according to the New York Heart Association （NYHA） criteria for CHF. All patients with CHF were treated with digitalis, angiotensln converting enzyme inhibitor （ACEI） , beta-receptor blockade, diuretics as routine. TNF-α, IL-6 and TGF-β1 were detected by EL1SA assay. The fasting blood samples were taken for examining from 56 CHF patients at the day after admitted to hospital and 15 days after routine treatment and 30 healthy subjects. The left ventrleular ejection fraction （LVEF） of CHF patients before and after treatment and normal subjects were measured by color Doppler echoeardiography for analyzing correlation of cardiac function and cytokines. Results Compared with control group, the levels of serum TNF-α, IL-6 and TGF-β1 in the heart failure group were significantly elevated （ P 〈 0.05 or P 〈 0. 01 ）. In the heart failure group, there was significant negative correlation between TNF-α,IL-6, TGF-β1 and LVEF （r1 = -0. 58 ,r2 = -0. 61 ,r3 = -0.59 respectively,all P 〈0. 01 ）. The levels of serum eytokines in patients with different pathogeny had no significant differences （all P 〉 0.05 ）. Conclusions The levels of serum TNF-α, IL-6 and TGF-β1 in patients with CHF are closely related to cardiac function and have no relation with pathogenys. They could contribute to judging patient＇s condition, therapeutic efficacy and prognosis.
出处
《中国厂矿医学》
2009年第3期260-261,共2页
Chinese Medicine of Factory and Mine
