心力衰竭患者肿瘤坏死因子、内皮素的变化及氯沙坦对其影响

Endothelin and tumor necrosis factor-α in congestive heart failure and their changes after losartan treatment

目的 :探讨心力衰竭患者肿瘤坏死因子 (TNF)、内皮素 (ET- 1)的变化及氯沙坦对其影响。方法 :采用放免法检测 44例心力衰竭患者及 2 2例健康者血 ET- 1和 TNF- α浓度。将 44例心力衰竭患者随机分为两组 :A组 :入选 2 1例 ,给予常规抗心力衰竭治疗 ;B组 :入选 2 3例 ,在 A组治疗药物的基础上加氯沙坦 5 0 m g,每日 1次 ,共 1个月。结果 :1心力衰竭患者 ET- 1和 TNF- α水平显著高于对照组 (P <0 .0 5 )。 2两组患者治疗后心力衰竭均有明显改善 ,但以氯沙坦治疗后 ET- 1和 TNF-α水平下降显著 (P <0 .0 5 )。结论 :ET- 1,TNF-α与心力衰竭的发生发展有关 ,氯沙坦治疗可降低心力衰竭患者 ET- 1,TNF-α水平。

Objective:The serum levels of tumor necrosis factor alpha (TNF α),endothelin 1 (ET 1) from 44 patients with congestive heart failure (CHF) and 22 of healthy people were studied by radioimmunoassay.Method:Patients were randomized to receive losartan in addition to routine therapy (n=23) or routine therapy only (n=21) for 1 month,with evaluations made before and after treatment.Result:①The serum levels of TNF α and ET 1 of the CHF group were higher than those of the control group (P< 0.05 ).②Both of the therapies were effective in improving the symptoms of CHF with no differences between their decrease of NYHA class,but only the patients treated with losartan lowered serum TNF α,ET 1 (P< 0.05 ).Conclusion:These findings indicate that TNF α,ET 1 play an important role in the pathophysiologic changes of CHF.Losartan can decrease the levels of TNF α and ET 1.