心力衰竭患者血清白细胞介素10和肿瘤坏死因子α的变化及意义

Changes of serum interleukin-10 level and tumor necrosis factor-alpha level in patients with congestive heart failure and its clinical significance

目的 探讨白细胞介素 10 (IL- 10 )和肿瘤坏死因子 α(TNF- α)在充血性心力衰竭 (CHF)中的作用和地位。方法 采用双抗体夹心 ABC- EL ISA法 ,测定 4 3例不同病因和心功能的 CHF患者和 16例正常对照组受试者血清IL - 10和 TNF-α浓度。结果 与对照组比 ,CHF患者血清 IL - 10浓度无显著性变化 (P>0 .0 5 ) ,并且不同心功能分级之间也无显著性差异 (P>0 .0 5 )。而血清 TNF-α浓度在 CHF组显著升高 (P<0 .0 1) ,且随着心功能分级增加 ,TNF-α浓度呈进行性增加 (P<0 .0 5 )。相关分析显示 IL - 10与 TNF-α、心功能分级及 6 m in步行距离均无相关性 (P>0 .0 5 ) ,与心力衰竭病程显著性正相关 (相关系数为 0 .33,P<0 .0 5 )。TNF- α与 6 m in步行距离及心功能分级有相关性 (相关系数分别为 - 0 .39,0 .6 4 ,P<0 .0 5 )。结论 心力衰竭时炎性细胞因子增加 ,抗炎性细胞因子不增加 ,细胞因子网络平衡紊乱可能参与 CHF的发生、发展。

Objective To evaluate the effect of interleukin-10(IL-10) and tumor necrosis factor-alpha(TNF-α) in congestive heart failure(CHF). Methods Serum levels of TNF-αand IL-10 were measured by enzyme-linked immunoassay in 43 CHF patients with different pathogenesis and heart function and in 16 healthy controls. Results Compared with control, serum IL-10 level in patients with CHF didn't have remarkable changes(P>0.05), also in different functional class of heart failure(P>0.05), but the levels of serum TNF-α had increased obviously(P< 0.01), along with increasing of heart functional class, serum TNF-α had increased gradually(P<0.05). Correlation analysis displayed that IL-10 had no relevance with TNF-α, heart functional class and distance of six-minute walk (P>0.05), but it have remarkable positively correlated with the pathogenic time of heart failure. TNF-α had correlation with distance of six-minute walk and heart functional class (-0.39, 0.62, P<0.05). Conclusion There are the levels of inflammatory cytokines inadequately raised and the levels of anti-inflammatory cytokines relatively lowered in CHF patients, the imbalance in the cytokine network may be involved in development and progression of CHF.