伊伐布雷定对慢性心力衰竭患者IL-6、TNF-α的影响

Effect of ivabradine on IL-6 and TNF-α in patients with chronic heart failure

【目的】观察伊伐布雷定对慢性心力衰竭患者白介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)的影响。【方法】连续入选在我院住院治疗的慢性心衰患者77例,窦性心率≥70次/min,随机分为2组,对照组继续心衰标准治疗,治疗组常规治疗基础上加用伊伐布雷定。所有患者入院后第2天清晨留取血清标本,测定血氨基末端脑钠肽前体(N terminal pro B type natriuretic peptide,NT-proBNP)、IL-6、TNF-α水平;入院24 h内行心脏彩超,测定心脏左室射血分数(left ventricular ejection fraction,LVEF)和左室舒张末期内径(left ventricular end diastolic diameter,LVEDD)。所有患者随访3个月,3个月后测定血NT-proBNP、IL-6、TNF-α水平,复查心脏彩超检查,测定LVEF、LVEDD。【结果】两组心衰患者基线临床资料无明显统计学差异;与治疗前相比,伊伐布雷定治疗3个月后LVEF升高,NT-proBNP、IL-6、TNF-α水平下降。与对照组相比,伊伐布雷定治疗组NT-proBNP明显降低、LVEF明显升高,炎症指标IL-6、TNF-α水平明显下降。【结论】心力衰竭患者加用伊伐布雷定治疗后,能进一步改善心衰,降低炎症指标IL-6、TNF-α水平。

【Objective】To observe the effect of ivabradine on interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in patients with chronic heart failure.【Methods】A total of 77 patients with chronic heart failure and sinus rhythm and baseline heart rate≥70 bpm were enrolled in this study.All the patients were randomly divided into 2 groups:control group(with conventional therapy,n=39)and ivabradine+conventional treatment group(n=38).Dosage of ivabradine was adjusted with the heart rate.The serum samples were collected from all patients in the early morning of the second day after admission.The levels of N terminal pro B type natriuretic peptide(NT-proBNP),IL-6,TNF-αwere determined.The left ventricular ejection fraction(LVEF)and left ventricular end diastolic diameter(LVEDD)were also measured via cardiac color Doppler ultrasonography within 24 h of admission.All the patients were followed up for 3 months.After 3 months,the same parameters were determined.【Results】There was no significant difference in clinical parameters between the two groups.After 3-month treatment,LVEF increased and the levels of NT-proBNP,IL-6 and TNF-αdecreased.Compared with the control group,the levels of NT-proBNP,IL-6 and TNF-αwere significantly lower in the treatment group and LVEF was higher.【Conclusion】Ivabradine can reduce the levels of IL-6 and TNF-α.It can further improve heart failure.