心力衰竭患者白细胞介素6表达和自然杀伤细胞活性的变化

Study of interleukin-6 expression and change of natural killer cells activity in patients with congestive heart failure

目的：探讨充血性心力衰竭（CHF）患者自然杀伤（NK）细胞活性的变化。方法：选择NYHAⅡ～Ⅳ级的CHF患者48例作为观察组，30例健康体检者作为对照组。应用流式细胞仪测定全血NK细胞数目，并应用酶联免疫吸附法测定血清、培养上清中白细胞介素6（IL-6）含量，应用改良MTT法测定NK细胞杀伤活性。结果：①CHF患者循环NK细胞和NK细胞杀伤活性显著降低，并与CHF程度呈负相关（r=-0．873，-0．949，均P〈0．01）；②CHF患者血清、培养上清和IL-2刺激后上清中IL-6显著增加（均P〈0．01），并与CHF程度呈正相关（r=0．988，0．984，0．982；均P〈0．01）；③IL-2刺激可能使CHF患者NK细胞杀伤活性增强（P〈0．01）。结论：NK细胞数目和活性下降可能是CHF患者免疫功能异常的机制之一；IL-2刺激可使CHF患者NK细胞杀伤活性增强；调节细胞免疫功能治疗可能改善CHF患者预后。

Objective：To explore the changes and significance of activity of natural killer cells in patients with congestive heart failure（CHF）. Method.. Thirty normal controls and Forty-eight patients with CHF were recruited according to NYHA standard. Levels of circulating NK cells were determined by flow cytometry. IL-6 in sera and in supernatants of PBMC cultured in vitro were quantitated by an enzyme-linked immunosorbent assay. NK cells killing activity were examined with modified MTT approach. Result：（1）Circulating NK cells and NK cells activity from patients with CHF decreased significantly（P〈0.01）, and were negtively correlated with the degree of heart failure（r= -0. 873,-0. 949,respectively; all P〈0.01）. （2）The levels of IL-6 in sera,in culture supernatants,and in culture supernatants stimulated with IL-2 increased singificantly （all P〈0.01）. And there was a positive correlation with the degree of heart failure（r= 0. 988,0. 984,0. 982, respectively; all P〈0.01）. （3） Cytolytic function of NK cells from patients with CHF increased significantly when they were stimulated with IL-2（P〈0. 01）. Conclusion：The kill activity of NK cells enhances by IL-2 stimilating in patients with CHF. It may be one of the mechanism of dysfunction of immune system to reduce NK cells and its activity in patients with CHF. It suggests that the regulation of cell immune function might be helpful to improve the prognosis of patients with CHF.