雷米普利对老年心力衰竭患者血清细胞因子的影响

Effects of ramipril on serum cytokines in elderly patients with heart failure

目的 研究老年心力衰竭患者血清细胞因子水平与心功能的关系以及雷米普利对血清细胞因子的影响。 方法 将76例老年心力衰竭患者随机分为雷米普利治疗组(36 例)和常规治疗组(40例),另设年龄、性别与之匹配的健康老年人作为对照组(30例)。应用双抗夹心ELISA法检测各组受试者血清肿瘤坏死因子α(TNF α)、可溶性肿瘤坏死因子受体(STNFRI)、白细胞介素6(IL 6)、白细胞介素10(IL 10)和转化生长因子βI(TGF βI)水平。常规治疗组和雷米普利组在治疗2周后复查上述指标。 结果 (1)血清TNF α、STNFRI、IL 6、IL 10 和TGF βI水平与老年心力衰竭患者的基础心脏病无关(P<0 05);上述血清细胞因子水平随心功能的恶化而升高(P<0 05 或P<0 01)。(2)与治疗前比较,雷米普利治疗组治疗前后血清TNF α〔(20 9±8 2)μg/L比(13 2±8 4)μg/L〕、sTNFRI〔(2 7±0 9)μg/L比(1 9±0 4)μg/L〕、IL 6〔(29 2±6 8) ng/L比(20 5±6 0) ng/L〕、IL 10〔(22 1±6 4) ng/L比(13 8±5 7) ng/L〕及TGF β1〔(2144 1±597 9) ng/L比(1348 8±342 4 )ng/L〕水平均下降(分别为P<0 05 或P<0 01),雷米普利治疗组比常规治疗组下降明显(P<0 01)。 结论 老年心力衰竭患者血清细胞因子与心功能密切相关,能够反映心力衰竭的程度;雷米普?

Objective To investigate the relationship between cytokines and cardiac function of elderly patients with heart failure(EPHF) and observe the effects of treatment with ramipril on serum cytokines in EPHF. Methods The EPHF were randomly divided into ramipril treatment group (36 cases) and routine treatment group (40 cases) Thirty elderly healthy subjects were taken control group, whose age and sex were matched with above two groups The levels of serum TNF α, sTNFRI, IL 6, IL 10 and TGF β I were determined by ELISA for each group For ramipril and routine treatment group, all above indices were measured again after 2 weeks of treatment respectively Results The levels of serum TNF α, sTNFRI, IL 6, IL 10 and TGF β I in patients with different pathogenic factors had no significant difference ( P >0 05) Compared with control group, the levels of serum TNF α, sTNFRI, IL 6, IL 10 and TGF β I in EPHF were significantly elevated ( P <0 05 or P <0 01) Furthermore, they increased gradually with the upgrade of cardiac function according to the cardiac functional classification of New York Heart Association (NYHA) After two weeks of treatment, serum levels of TNF α, sTNFRI, IL 6, IL 10 and TGF β I in ramipril treatment group were significantly decreased ( P <0 05) and in ramipril treatment group had higher decrease than those in routine treatment group ( P <0 01) Conclusions The levels of serum cytokines in EPHF are closely related to cardiac function, but has no relation with pathogenic factors Activation of cytokines might play an important role in promoting the progression of heart failure and the deterioration of cardiac function In addition to improving cardiac function, ramipril can decrease the levels of serum cytokines in heart failure