慢性心力衰竭患者单核细胞分泌TNF-α变化及开博通对其影响的研究

Changes of Tumor Necrosis Factor in Patients With Chronic Heart Failure and Influence of Angiotensin-Converting Enzyme Inhibitor

目的 :通过测定慢性充血性心力衰竭 (CHF)患者单核细胞分泌肿瘤坏死因子α(TNF α)的改变 ,及血管紧张素转换酶抑制剂开博通对其的影响 ,探讨TNF α在CHF发病中的作用 ,可能来源及与肾素 血管紧张素系统的关系。方法 :测定 30例CHF患者及 2 0例健康人的血清TNF α含量。收集 30例CHF患者及 2 0例健康人外周血单个核细胞 (PBMC) ,应用RPMI 16 4 0培养基进行培养 ,并加入血管紧张素转换酶抑制剂开博通 ,使开博通终浓度为0 ,10 -10 ,10 -9,10 -8mmol/L ,2 4h后取培养上清液 ,用ELISA法测定培养液TNF α含量。结果 :CHF患者血清TNF α含量明显高于对照组。血管紧张素转换酶抑制剂开博通对CHF组PBMC分泌TNF α有抑制作用 ,并呈剂量依赖性。结论 :CHF患者TNF α表达增加 ,提示TNF α可能参与了心力衰竭的发生发展过程。PBMC可能是心衰时TNF α表达增加的一个来源。TNF α表达增加可能与心力衰竭时肾素 血管紧张素系统被激活有关。

Objective: Our aim was to study the changes of tumor necrosis factor α(TNF α)in patients with chronic heart failure(CHF)and influence of angiotensin converting enzyme inhibitor (ACEI) on it.Methods:Levels of TNF α in plasma was determinded with emzyme link immunnosorbent assay in 30 patients with CHF and 20 healthy controls .Their peripheral blood monocytes (PBMC) were isolated and cultured in RPMI 1640 medium. Results: Level of TNF α in PBMC of patients was higher than that of controls. ACEI can inhibit the expression of TNF α.Conclusion:The expression of tumor necrosis factor in patients with CHF was up regulated,and ACEI can inhibit the expression of TNF α,which suggests TNF α and renal angiotensin system interact in the development of CHF.