慢性心力衰竭患者血清细胞因子和神经内分泌因子表达相关性探讨

Expression and relationship of serum cytokines and neuroendocrine factors in patients with chronic heart failure

目的慢性心力衰竭(chronic heart failure,CHF)是心血管疾病的主要死因之一,其病理生理机制较为复杂,免疫系统和神经内分泌系统的长期过度激活在CHF的发生和发展过程中起重要作用。本研究探讨患者血清细胞因子和神经内分泌因子的水平及关系,为CHF的防治提供新思路。方法选取2016-10-01-2017-12-31郑州人民医院收治的CHF患者115例为病例组,根据心功能分为Ⅱ级组(36例)、Ⅲ级组(45例)和Ⅳ级组(34例)。选择同院同期健康体检的正常人50名作为对照组。检测各组血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白介素-1β(interleukin-1β,IL-1β)、白介素-6(interleukin-6,IL-6)、血管紧张素Ⅱ(angiotensinⅡ,AngⅡ)、脑钠肽(brain natriuretic peptide,BNP)和心钠素(atrial natriuretic peptide,ANP)水平。采用Pearson分析其相关性。结果病例组患者血清TNF-α、IL-1β、IL-6、AngⅡ、BNP和ANP水平均高于对照组,差异有统计学意义,均P<0.05;并且Ⅳ级组上述细胞因子和神经内分泌因子水平高于Ⅱ和Ⅲ级组,Ⅲ级组高于Ⅱ级组,差异有统计学意义,均P<0.05。病例组患者血清TNF-α、IL-1β和IL-6水平,与AngⅡ、BNP和ANP水平均呈正相关,均P<0.05。结论 CHF患者血清细胞因子和神经内分泌因子水平发生异常变化,并与心功能恶化程度有关;两者表达呈正相关,共同参与CHF的发生发展。

OBJECTIVE Chronic heart failure(CHF)was the main causes of death of cardiovascular diseases,having complex pathophysiological mechanism.Long-term over-activation of the immune system and neuroendocrine system played an important role in the occurrence and development of CHF.This study was explored that the expression and relationship of serum cytokines and neuroendocrine factors in patients with CHF,in order to provid new ideas for the prevention and treatment of disease.METHODS A total of 115 patients with CHF in Zhengzhou People’s Hospital from2016-10-01 to 2017-12-31 were investigated as case group,including gradeⅡgroup(36cases),gradeⅢgroup(45cases)and gradeⅣ group(34cases)according to cardiac function.Fifty healthy people were studied as control group.Serum of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-6(IL-6),angiotensin Ⅱ(Ang Ⅱ),brain natriuretic peptide(BNP)and atrial natriuretic peptide(ANP)were determined.The correlation was analyzed by Pearson.RESULTS The levels of serum TNF-α,IL-1β,IL-6,Ang Ⅱ,BNP and ANP in case group were significantly higher than those in the control group(all P<0.05).The levels of the above cytokines and neuroendocrine factors in gradeⅣ group were significantly higher than those in the gradeⅡ group and gradeⅢ group(all P<0.05),and the levels in gradeⅢgroup were significantly higher than those in the gradeⅡ group(all P<0.05).The serum levels of TNF-α,IL-1βand IL-6in the case group were positively correlated with AngⅡ,BNP and ANP(all P<0.05).CONCLUSIONS The levels of serum cytokines and neuroendocrine factors in patients with CHF abnormally change,which are related to the degree of deterioration of cardiac function.The cytokines and neuroendocrine factors are positively correlated with each other and participate in the development of CHF together.