不同心肌病充血性心力衰竭患者细胞因子的变化

A study of cytokines in different cardiomyopathy in heart failure

目的 :探讨细胞因子在不同心肌病充血性心力衰竭 (CHF)中升高的触发机制。方法 :选择不同心肌病CHF患者 6 0例 (缺血性心肌病和扩张型心肌病各 30例 ) ,并选择 30例匹配的正常人作为对照组 ,放射免疫法检测肿瘤坏死因子 - α(TNF- α)、白细胞介素 - 1 (IL- 1 )、IL- 6和神经激素〔醛固酮 (AL D)、心钠素 (ANP)、肾素 (PRA)、血管紧张素 (AT )〕。结果 :TNF- α、IL- 1、IL- 6在 CHF患者中较正常人明显增高 (P <0 .0 0 1 )。不同心肌病CHF患者 ,在相同心功能分级时细胞因子水平无显著性差异。 TNF- α的升高与 ANP水平以及 IL- 6的升高与AL D水平均呈正相关。结论 :细胞因子在 CHF中起重要作用 ;但与不同心肌病无关。

Objective:To study the mechanism of the elevation of TNF α,IL 1 and IL 6 in heart failure caused by different cardiomyopathies.Method:Baseline concentration of TNF α,IL 1 and IL 6 and neurohormones were measured from peripheral venous plasma in 30 healthy control and 60 adult cardiac patients (30 with idiopathic dilated cardiomyopathy and 30 with ischemic cardiomyopathy).Result:Plasma levels of TNF α, IL 1 and IL 6 were significantly elevated in heart failure patients than those in age matched control subjects (P< 0.001 ).Cytokine concentrations did not differ in the same NYHA function classification in heart failure patients of different cardiomyopathies.Elevated plasma levels of TNF α and IL 6 were positively correlated with atrial natriuretic polypeptide (ANP) and aldosterone (ALD) separately.Conclusion:The cytokines play an important role in the pathogenesis of chronic heart failure.There is no difference between two types of cardiomyopathies in heart failure.