心力衰竭患者血浆细胞因子变化与心功能的关系

摘要

目的：分析心力衰竭患者血浆细胞因子变化与心功能的关系。方法：选择2011年8月至2013年8月我院收治的58例心力衰竭患者为心衰组，另选同期来我院进行体检的58名健康人群作为健康对照组，运用酶联免疫吸附试验（ELISA）检测其 C 反应蛋白（CRP）、白介素-6（IL-6）、肿瘤坏死因子－α（TNF-α）、Th1／Th2细胞因子干扰素-γ（IFN-γ）、白介素-4（IL-4）水平，并进行比较。结果：与健康对照组比较，心衰组 NYHAⅡ级、NYHAⅢ级、Ⅳ级患者的 CRP [（3.57±1.15）mg／L 比（6.21±1.89）mg／L、（6.89±2.02）mg／L、（7.57±2.11）mg／L]、TNF-α[（4.31±2.09）ng／L 比（13.97±3.24）ng／L、（16.23±3.59）ng／L、（18.55±3.61）ng／L]、IL-6[（8.25±1.2）ng／L 比（19.27±4.26）ng／L、（25.78±4.89）ng／L、（34.44±6.12）ng／L]水平均明显升高；外周血IFN-γ水平[（48.21±7.52）pg／ml 比（68.63±8.24）pg／ml、（73.91±10.14）pg／ml、（82.44±11.58）pg／ml]、IFN-γ／ IL-4[（1.07±0.12）比（1.73±1.26）、（2.09±1.31）、（2.38±1.40）]均显著升高（P 均＜0.05）；NY-HAⅢ级、Ⅳ级患者的外周血 IL-4[（45.11±6.97）pgl／ml 比（35.31±5.47）pgl／ml、（34.56±4.92）pgl／ml]水平显著降低（P 均＜0.05）。NYHAⅢ级、Ⅳ级患者的外周血 IFN-γ、IFN-γ／IL-4显著高于 NYHAⅡ级组患者，且NYHAⅣ级组患者又显著高于Ⅲ级组的（P 均＜0.05）。结论：心力衰竭患者血浆细胞因子与心功能密切相关。%Objective:To analyze the relationship between plasma cytokine changes and cardiac function in patients with heart failure.Methods:A total of 58 patients with heart failure treated in our hospital from Aug 2011 to Aug 2013 were selected as heart failure group,another 58 healthy people undergoing physical examination in our hospital during the same period were regarded as healthy control group.Enzyme linked immunosorbent assay (ELISA)was used to measure levels of C reactive protein (CRP),interleukin- 6 (IL-6),tumor necrosis factor-α (TNF-α), Th1/Th2 cytokine interferon-γ(IFN-γ)and interleukin-4 (IL-4),and the results were compared between two groups.Results:Compared with healthy control group,there were significant rise in levels of CRP [(3.57±1.15) mg/L vs.(6.21 ± 1.89)mg/L,(6.89 ± 2.02)mg/L,(7.57 ± 2.11)mg/L],TNF-α [(4.31 ± 2.09)ng/L vs. (13.97±3.24)ng/L,(16.23±3.59)ng/L,(18.55±3.61)ng/L]and IL-6 [(8.25±1.2)ng/L vs.(19.27±4.26) ng/L,(25.78±4.89)ng/L,(34.44± 6.12)ng/L];and significant increase in peripheral blood levels of IFN-γ[(48.21±7.52)pg/ml vs.(68.63±8.24)pg/ml,(73.91±10.14)pg/ml,(82.44±11.58)pg/ml]and IFN-γ/IL-4 [(1.07±0.12)vs.(1.73±1.26),(2.09± 1.31),(2.38± 1.40)]in patients with NYHA class Ⅱ,Ⅲ and Ⅳfrom heart failure group (P <0.05 all);and significant reduction in peripheral level of IL-4 [(45.11±6.97)pgl/ml vs.(35.31±5.47)pgl/ml,(34.56±4.92)pgl/ml]in patients with NYHA class Ⅲ and Ⅳ,P <0.05 both.The IFN-γand IFN-γ/IL-4 levels in patients with NYHA class Ⅲ and Ⅳ were significant higher than those of NYHA class Ⅱ,and those of NYHA class Ⅳ group were significant higher than those of NYHA class Ⅲ group,P <0.05 all.Conclusion:Plasma cytokine levels are closely related to cardiac function in patients with heart failure.