西拉普利对充血性心力衰竭患者细胞因子和心功能的影响

将37例充血性心力衰竭患者分为西拉普利组19例，常规治疗组18例，测定治疗前后血清IL-6、IL-8、IL-10、肿瘤坏死因子-α水平及心脏超声检测左室射血分数、左室舒张末期内径、心输出量、缩短分数；另设正常对照组40例，只检测细胞因子水平。结果示心力衰竭患者血清细胞因子水平均显著高于正常对照组（均P〈0．01）。西拉普利组治疗后血清IL-6、IL-8、TNF-α水平较治疗前显著下降（P〈0．01或0．05），IL-10水平有上升趋势（P=0．195）；心脏超声除左室舒张末期内径外各项指标均显著改善（P〈0．01）；治疗后IL-6水平与常规治疗组比较差异有统计学意义（P〈0．05）；治疗后心脏超声各指标与常规治疗组比较差异无统计学意义（P〉0．05）。而常规治疗组治疗前后仅左室射血分数和缩短分数改善（P〈0．01）；细胞因子水平无显著变化。提示充血性心力衰竭患者细胞因子平衡紊乱，西拉普利能降低促炎性细胞因子浓度，可能升高抗炎性细胞因子浓度，从而保护和改善心功能。

Effect of Cilazapril on cytokines and cardiac function in patients with congestive heart failure

Thirty seven patients with congestive heart failure (CHF) were divided into cilazapril group (n=19) and general treatment group (n=18). Serum levels of interleukin-6 (IL-6) ,interleukin-8 (IL-8) , interleukin-10(IL-10) and tumor necrosis factor-α(TNF-α) , left ventricular ejection fraction (LVEF) ,left ventricular end-diastolic diameter (LVEDD), cardiac output (CO) and fractional shortening (FS) were measured before and after treatment. Serum levels of cytokines were also measured in 40 healthy individuals (control group). Results: The serum levels of IL-6, IL-8, IL-10 and TNF-α in CHF patients were significantly higher than those in the control group ( all P<0.01 ) ; After treatment, the serum IL-6, IL-8 and TNF-α were significantly decreased (P<0.01 ,P<0.05 ) in the cilazapril group. The LVEF, FS, CO were significantly increased in the Cilazapril group ( P<0.01 ) ; And the serum levels of IL-6 were significantly decreased in the cilazapril group as compared with the general treatment group ( P<0.05 ), however, after treatment, the EF, LVEF, FS and CO had no statistical differences in the cilazapril group as compared with the general treatment group. In the control group only LVEF and FS improved(P<0.01) ; Cytokine levels showed no changes. It suggests that cilazapril can reduce the serum levels of pro-inflammatory cytokines, increased the serum levels of anti-inflammatory cytokine, protect and improved cardiac function in the patients with congestive heart failure.