氯沙坦对中重度心力衰竭患者血浆细胞因子的影响

Effects of losartan on cytokines for cases of moderate and severe heart failure

目的 :探讨细胞因子在中重度心力衰竭 (CHF)患者变化的触发机制及氯沙坦 (losartan)干预的效果。方法 :选取CHF患者 4 1例和正常人 2 0例 ,采用放射免疫法测定血浆肿瘤坏死因子 (TNF α)、白细胞介素 1(IL 1)和白细胞介素 6 (IL 6 )的水平。CHF患者 2 0例常规治疗 ,2 1例加用氯沙坦 ,治疗 4周后再测定上述指标。结果 :治疗前患者 3种细胞因子血浆水平均高于正常人 ,且心功能越差 ,其血浆水平越高 ;不同病因所致同级CHF的细胞因子水平差异无统计学意义 (P >0 .0 5 ) ;氯沙坦治疗后 ,患者心功能改善情况好于常规治疗 ,且上述细胞因子的水平降低(P <0 .0 0 1)。结论 :细胞因子在CHF的发展中可能起重要作用 ,且与基础病无关。氯沙坦在改善心功能的同时 。

Aim: To study the changes of cytokines in patients with moderate and severe congestive heart failure the mechanism,and their response to losartan.Methods: The subjects included investigation group with CHF ( n =41) and healthy control group ( n =20). The investigation group was regrouped into conventional and conventional plus losartan groups.Plasma levels of tumor necrosis factor α(TNF α), interleukin 1(IL 1),and interleukin 6(IL 6) were measured by using radioimmunoassay before treatment and one month later.Results: The plasma levels of all the 3 cytokines of investigation group were higher than those of the control group,and increased with severity of heart failure.There was no difference between them in patients with the same severity of heart failure by different causes ( P >0.05). Losartan improved cardiac function and lowered the plasma levels of all the three cytokines ( P <0.001).Conclusion: Cytokines may play an important role in the development of heart failure despite different underlying diseases. Losartan can improve cardiac function and lower the cytokines levels.