摘要
目的 本研究旨在探讨细胞因子在不同心肌疾病心衰中的升高触发机制。方法 选择心衰病人 6 0例 (扩张性心肌病 (DCM)、缺血性心肌病 (ICM)各 30例 ) ,并选择 30例正常人作为对照组 ,检测肿瘤坏死因子 -α(TNF-α)、白细胞介素 - 1(IL- 1)、白细胞介素 - 6 (IL- 6 )和神经内分泌激素 (醛固酮 (AL D) ,肾素 (PRA) ,血管紧张素 (AT ) ,心钠素 (ANP) )。结果 TNF- α、IL- 1、IL- 6在心衰病人中较正常人明显增高 (P <0 .0 0 1)。两种心肌病的心衰患者 ,在相同纽约心脏病协会心功能分级 (NYHAFC)时细胞因子水平无显著差异。TNF-α的升高与 ANP水平以及 IL - 6的升高与 AL D水平均有正相关。结论 细胞因子在慢性心力衰竭 (CHF)中起到了重要作用 ;
Objective To discuss the mechanism of the elevations of TNF α, IL I and IL6 in heart failure caused by different cardiomyopathy.Methods Baseline concentrations of TNF α, IL I and IL 6 , and neurohormones including ALD, PRA, ATII and ANP were measured from peripheral venous plasma in 30 healthy controls and 60 adult cardiac patients (30 with idiopathic dilated cardiomyopathy and 30 with ischemic cardiomyopathy) who were either in patients or out patients of Department of Cardiology. Results 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 between two kinds of cardiomyopathy in heart failure of same NYHA function classification. Elevated plasma levels of TNG αand IL 6 correlated positively with atrial natriuretic polypeptide (ANP) and aldosterone (ALD) respectively.Conclusion The cytokines play an important role in the pathogenesis of chronic heart failure. One of the reasons for its elevation may be due to neurohormonal activation.
