558例慢性心衰血炎性细胞因子变化的临床意义

Clinical Significance of Changes of Cytokines in 558 Patients with Chronic Congestive Heart Failure

目的:了解血炎性细胞因子(肿瘤坏死因子α)(TNFα)、白介素-1β、白介素-6(IL-6)与慢性心衰心脏功能和病因的关系。方法:对558例慢性心衰,30例慢性阻塞性气管炎、阻塞性肺气肿,87例肺心病,30例2型糖尿病,70例正常对照组的血TNFα、IL-1β、IL-6作了临床观察,对冠心病、高血压、肺心病及冠心病合并肺心病严重心衰作了1:1:1:1的病例对照研究。结果:心衰患者TNFα、IL-1β、IL-6高于正常人(P<0.001);严重心衰患者上述炎性细胞因子增加明显,与心功能级数成正相关,与射血分数成负相关;病例对照研究发现冠心病合并肺心病血炎性细胞因子水平最高,依次为冠心病、高血压、肺心病。结论:TNFα、IL-1β、IL-6参与心衰心室重构,其血中水平受病因影响。

Objective: The aim of study was to assess clinical significance of changes of cytokines in chronic congestive heart failure. Methods and results: Plasma tumor necrosis factoralpha ( TNFα), interleukin -1 beta (IL - 1β) and interleukin - 6 (IL - 6) were measured in 558 patients with CHF, 30 patients with COPD,87 patients with CPHD,30 patients with diabetic mellitus and 70 normal persons. And casecontrol study was performed in patinets with CHF. Analysis of the patients showed that increasing circulating levels of TNFα,IL- 1β and IL- 6 were assocaited with LVEF and NYHA classes in advanced HF. TNFα in COPD,CPHD and DM was higher than that in normal person. Moreover .circulating levels of cytokines were greatest in patients with ischemic heart failure with chronic pulmonary heart disease. Conclusions: Cytokines were associated with ventricular remodeling in CHF, and circulating levels of cytokines are modified by canse of heart failure.