曲美他嗪对老年心脏衰竭患者血清IL-18的影响机制

目的观察白细胞介素-18（IL-18）在老年心脏衰竭患者中的变化,以及曲美他嗪的干预作用。方法2011接诊24例老年心脏衰竭患者,根据随机数字法分为心衰对照组12例,心衰曲美他嗪干预组12例,其中心衰曲美他嗪干预组应用曲美他嗪4周。另选取本院体检健康同龄人30例作为健康对照组,心脏彩超测定心肌肥厚程度及左室射血分数（EF）。应用酶联免疫吸附法ELISA测量IL-18。结果 （1）EF及左室体重指数结果：相比于健康对照组,心衰对照组及曲美他嗪干预组显著较高,差异具有显著统计学意义（P〈0.001）。（2）IL-18含量：心衰对照组及曲美他嗪干预组显著高于健康对照组（P〈0.001）,而且心衰对照组显著高于曲美他嗪干预组,差异具有显著统计学意义（P〈0.001）。结论通过在3组中的IL-18的含量对比,显示了IL-18在心力衰竭发病机制中所起到的介导作用,以及反映心衰的发病程度,曲美他嗪可能通过纠正细胞因子的网络失衡发挥改善心衰作用。

Impact of trimetazidine on the concentration of interleukin-18 in senile chronic heart failure patients

Objective To observe the impact of trimetazidine on the change of changes of interleukin-18（IL-18） level in chronic heart failure patients.Methods The 24 senile chronic heart failure case diagnosed in 2011 were divided into trimetazidine intervention group treated with trimetazidine for a course of 4 weeks and heart failure group,each consisted of 12 cases.Another 30 healthy persons were selected as controls.The degree of cardiac hypertrophy and left ventricular ejection fraction（EF）were determined by using echocardiography,and the level of IL-18 was determined by ELISA.Results The EF and left ventricular weight index： in heart failure control group and trimetazidine intervention group were significantly higher compared to the sham group（healthy control group）,（P〈0.001）.The levels of IL-18 in heart failure and qumei trimetazidine intervention group were also significantly higher than that in the sham group（P〈0.001）,and that of the heart failure control group was also significantly higher than that of trimetazidine intervention group,showing statistically significant differences（P〈0.001）.Conclusions The level of IL-18 might play an intermediate role in the pathogenesis of heart failure and it may also reflect the degree of heart failure,and trimetazidine possiblely involves the improvement of heart failure by modifying the imbalance of cytokine network.