充血性心力衰竭患者某些细胞因子的变化及胺碘酮对其影响的研究

Study of the Change of Some Cytokines in Patients With Congestive Heart Failure and Effect of Amiodarone on the Production of the Cytoknes in Vitro.

检测充血性心力衰竭 (CHF)患者血清肿瘤坏死因子 α(TNF α)、白细胞介素 1β(IL 1β)和IL 6的变化 ,以及胺碘酮对培养的正常人及CHF患者单核细胞 (PBMC)分泌上述细胞因子的影响 ,以明确上述细胞因子在CHF发生过程中的作用 ,以及胺碘酮作用于CHF的免疫学机制。取 2 0例正常人和 2 0例Ⅲ～Ⅳ级的CHF患者静脉血 :①测其血清TNF α、IL 1β和IL 6含量 ;②离心取PBMC ,分别加入胺碘酮和脂多糖 (LPS)等 ,使胺碘酮的终浓度为 0 ,0 .1,1和10 μmol/ml进行培养 ,经 2 4h孵化后 ,取培养液上清 ,用酶联免疫吸附法 (ELISA)测培养上清中TNF α、IL 1β和IL 6。结果 :CHF患者血清TNF α、IL 1β和IL 6明显高于对照组 (P均 <0 .0 0 1) ,并随心衰程度的加重而增加 (P <0 .0 0 1)。TNF α与IL 1β和IL 6呈正相关 (r=0 .96 84,0 .9786 ;P均 <0 .0 0 1)。胺碘酮对两组PBMC分泌TNF α、IL 1β和IL 6均具有抑制作用 ,并呈剂量依赖性。结论 :①细胞因子TNF α、IL 1β和IL 6参与CHF的发生 ;②胺碘酮可能通过抑制细胞因子的产生 ,对心力衰竭患者产生改善心功能作用。

To examine the change of serum tumor necrosis α(TNF α),interleukins 1β(IL 1β) and IL 6 in patients with congestive heart failure(CHF) and the effect of amiodarone on the prodution of the cytokines in vitro.Vein blood of both healthy volunteers( n =20),and CHF patients( n =20) were obtained.Serum TNF α,IL 1β and IL 6 were measured by an Enzyme linked immunosorbent assay(ELISA).Peripheral blood mononuclear cell(PBMC) were obtained from both the control and the patients group.PBMC were cultured with 0,0.1,1,and 10 μmol/l of amiodarone in the presence of lipopolysaccharide.After 24 hours' incubation,TNF α,IL 1β and IL 6 were measured in the culture supernatants by an ELISA.Results:Serum TNF α,IL 1β and IL 6 were significantly higher than that of the control group( P< 0.001),and the higher the heart failure degree,the higher the levels of the cytokines( P< 0.001).TNF α positively correlate both with IL 1β( r=0.9684,P< 0.001) and IL 6( r=0.9768,P< 0.001).The production of TNF α,IL 1β and IL 6 were greatly inhibited by amiodarone in both groups in a concentration depended manner.Conclusion:①TNF α,IL 1β and IL 6,may play an important role in the pathogenesis of CHF;②The effect of improvement of heart function of amiodarone may be caused by the inhibition of the production of some certain cytokines.