心力衰竭患者心功能与细胞因子及神经激素的关系

Relationship of cardiac function with cytokines and neurohomone in patients with chronic heart failure

目的探讨慢性心力衰竭患者血浆细胞因子、神经激素的变化及其与心功能的关系。方法用酶联免疫双抗体夹心法测定122例慢性心力衰竭患者及30例健康人血浆中肿瘤坏死因子α(tumornecrosisfactoralpha,TNF-α)、白细胞介素-6(interleukine-6,IL-6)的浓度,放免法测定血浆肾素活性、血管紧张素Ⅱ(angiotensionⅡ,AngⅡ)浓度,荧光测定法测定血浆儿茶酚胺、去甲肾上腺素(norepinephrine,NE)的浓度。结果①慢性心力衰竭患者血浆中TNF-α水平明显高于对照组[对照组(13.09±2.47)ng/L],差异有显著性意义(P<0.05～0.01),且随着心力衰竭程度的加重,TNF-α水平呈进行性增高[Ⅱ级(18.85±2.82)ng/L,Ⅲ级(26.65±9.78)ng/L,Ⅳ级(38.01±19.21)ng/L];IL-6水平在心功能Ⅲ,Ⅳ级组中明显高于对照组[(18.72±8.28),(24.63±10.76)和(14.71±1.30)ng/L],差异有显著性意义(P<0.05～0.01),而心功能Ⅱ级组[(16.24±4.02)ng/L]与对照组相比差异无显著性。心功能Ⅲ、Ⅳ级组心力衰竭患者血中肾素活性、AngⅡ、儿茶酚胺、NE的浓度明显高于对照组(P<0.01)。②TNF-α与肾素活性、AngⅡ、儿茶酚胺、NE呈正相关(r=0.439,0.608,0.440,0.441,P<0.01),IL-6与肾素活性、儿茶酚胺、NE呈正相关(r=0.319,0.411,0.420,P<0.01)。结论神经激素-细胞?

AIM:To explore the changes of plasma cytokines and neurohomone,and the relationship between neurohomone cytokines and cardiac function in patients with chronic heart failure(CHF).METHODS:The plasma levels of tumor necrosis factor alpha(TNF α) and interleukin 6(IL 6) were examined by ELISA,plasma renin activity(PRA) and angiotensin II (AngII) level were examined by radioimmunoassay,and the levels of plasma catecholamine(CA)and norepinephrine(NE) were examined by fluorophotometry in 122 CHF paitents and 30 normal controls.RESULTS:①Plasma level of TNF αin the CHF group was significantly higher than that in the control group[(13.09±2.47) ng/L](P< 0.05-0.01).The severer the degree of heart failure,the higher the plasma TNF αlevels[grade Ⅱ:(18.85±2.82) ng/L,grade Ⅲ:(26.65±9.78) ng/L and grade Ⅳ:(38.01±19.21) ng/L].The IL 6 levels in the cardiac function grade Ⅲgroup[(18.72±8.28) ng/L] and grade IV group[(24.63±10.76) ng/L] were significantly higher than that in the control group[(14.71±1.30) ng/L](P< 0.05-0.01),but there were no difference between grade II group[(16.24±4.02) ng/L] and control group.The PRA,AngII,CA and NE levels were higher in the cardiac function grades III and IV groups than in the control group(P< 0.01).②TNF αwas positively correlated with PRA,AngII,CA and NE(r=0.439,0.608,0.440,0.441,P< 0.01).IL 6 was positively correlated with PRA,CA and NE(r=0.319,0.411,0.420,P< 0.01).CONCLUSION:Neurohormone cytokines network is closely associated with cardiac function in patients with CHF.There are positive correlations between rennin and angiotensin,between cytokines and neurohormone.The interaction of the network may be involved in the development and progression of CHF.