充血性心力衰竭患者TNF-α和IL-6变化及临床意义

目的 :探讨充血性心力衰竭患者肿瘤坏死因子 (TNF α) ,白细胞介素 6 (IL 6 )的变化及意义。方法 :56例充血性心力衰竭患者和 30例健康体检者为研究对象 ,采用酶联免疫双抗体夹心法测定血清TNF α ,IL 6浓度 ,用二维心脏超声测定左室射血分数 (LVEF)。结果 :1 血清IL 6、TNF α、去甲肾上腺素 (NE)在CHF各组均升高 ,但心功能Ⅱ级组与对照组比较差异不显著 (P >0 0 5) ;心功能Ⅲ级 ,Ⅳ级组IL 6 ,TNF α ,NE明显高于心功能Ⅱ级和对照组 (P均 <0 0 5)。IL 6、TNF α、NE与LVEF呈高度负相关(r=- 0 6 3,P <0 0 1 ;r=- 0 54,P <0 0 5;r=- 0 58,P <0 0 1 )。 2 随心衰程度加重 ,血清TNF α、IL 6和NE浓度越高。TNF α与NE ,IL 6与NE呈明显正相关 (r =0 57,P <0 0 1 ;r =0 51 ,P <0 0 5)。 3 随心衰程度加重 ,血清IL 6与TNF α浓度越高 ,且二者呈正相关 (r =0 39,P <0 0 5)。结论 :CHF患者血清TNF α和IL 6浓度升高 ,尤其中重度CHF患者更加明显 ,并与LVEF呈负相关 ,提示血清IL 6、TNF α水平可作为CHF严重程度的判断与预后指标。     

高尿酸血症血尿酸与TNF-α、IL-6的关系

测定高尿酸血症及其合并糖脂代谢紊乱患者血清肿瘤坏死因子α（TNF-α）与白细胞介素6（IL-6）水平，结果显示高尿酸血症患者TNF-α、IL-6水平明显高于正常对照者（均P〈0．01），高尿酸血症并发糖脂代谢紊乱时血清TNF-α、IL-6水平升高更为显著。     

胃癌患者血清IL-6、IL-8和TNF-α水平变化

目的观察胃癌患者血清IL-6、IL-8和TNF-α水平变化。方法采用ELISA法测定80例胃癌（胃癌组）患者、30例胃良性病变（良性组）和20例健康者（正常组）血清IL-6、IL-8和TNF-α水平。结果胃癌患者血清IL-6、IL-8和TNF-α水平明显高于良性组和正常组（P均〈0.05）;Ⅲ、Ⅳ期胃癌患者血清IL-6、IL-8和TNF-α水平明显高于Ⅰ、Ⅱ期（P均〈0.05）;肿瘤根治手术后血清IL-6、IL-8和TNF-α水平较术前明显降低（P均〈0.05）,但仍高于正常对照组（P均〈0.05）。良性组血清IL-6、IL-8和TNF-α水平与正常组差异无显著性（P均〉0.05）。结论胃癌患者IL-6、IL-8和TNF-α水平增高,且增高程度与临床分期有关。     

卵巢癌患者血清TNF-α、IL-6、IL-8水平变化及其临床意义

研究证实,机体免疫功能调节障碍,而免疫功能,尤其是细胞免疫功能的状态与肿瘤的发生、发展和预后密切相关。TNF-α、IL-6、IL-8是单核巨噬细胞、内皮细胞和淋巴细胞所分泌的细胞因子,在机体的抗肿瘤免疫调节中起重要作用。2002年1月至2004年1月,我们测定了65例卵巢癌患者血清TNF-α、IL-6和IL-8变化,现探讨其临床意义。     

胃癌患者血清IL-6、IL-8、TNF-α水平变化及意义

目的观察胃癌患者血清IL-6、IL-8和肿瘤坏死因子α（TNF-α）水平变化,并探讨其临床意义。方法采用ELISA法测定50例胃癌患者（观察组）和20例健康对照者（对照组）血清IL-6、IL-8和TNF-α水平。结果观察组患者血清IL-6、IL-8和TNF-α水平明显高于对照组（P均〈0.05）。观察组Ⅲ、Ⅳ期胃癌患者血清IL-6、IL-8和TNF-α水平明显高于Ⅰ、Ⅱ期患者（P均〈0.05）。结论 胃癌患者IL-6、IL-8和TNF-α水平增高。这可能与胃癌的发生、发展有关。     

脑梗死患者血清TNF-α、IL-6含量的变化及意义

本研究旨在通过检测老年动脉硬化性脑梗死患者急性期和恢复期血清肿瘤坏死因子-α(TNF-α)、白细胞介素6(IL-6)含量变化,探讨检测细胞因子在脑梗死发展过程中的价值及意义,为临床防治提供理论依据。1资料与方法1.1一般资料66例均为我院神经内科住院急性脑梗死(ACI)患者,男40例,     

重症肺炎并心力衰竭患者血清TNF-α、IL-6、NO、CK-MB的变化及其临床意义

目的探讨研究重症肺炎并心力衰竭患者血清肿瘤坏死因子(TNF-α)、白细胞介素6(IL-6)、一氧化氮(NO)、肌酸激酶心肌同工酶(CK-MB)的含量变化情况及临床意义。方法选择25例重症肺炎并心力衰竭患者及30例非重症肺炎患者,测定其患者治疗前后的血清TNF-α、IL-6、NO、CK-MB的含量。结果重症肺炎并心力衰竭患者血清TNF-α、IL-6、NO、CK-MB的浓度明显高于非重症肺炎患者P<0.01)。治疗后,重症肺炎并心力衰竭患者血清TNF-α、IL-6、NO、CK-MB的浓度较治疗前明显下降(P<0.01);非重症肺炎患者血清TNF-α、IL-6、NO、CK-MB的浓度变化无显著性差异(P>0.05)。结论当重症肺炎并心力衰竭时,炎性细胞因子可显著升高,引起患者的心肌损害,心肌收缩力减弱,心脏血液搏出量下降并发心衰。提示在重症肺炎患者早期时注重积极有效抗感染降低炎性因子的介导作用,保护心肌防止心衰治疗。     

胃癌患者血清TNF-α、IL-6、IL-8水平变化及意义

目的观察胃癌患者血清肿瘤坏死因子-α（TNF-α）、IL-6、IL-8的水平变化,并探讨其临床意义。方法采用ELISA法测定60例胃癌（胃癌组）、25例胃良性病变患者（良性组）血清TNF-α、IL-6、IL-8,并与25例健康者（正常组）作对照。结果胃癌组血清TNF-α、IL-6、IL-8水平明显高于良性组和正常组（P〈0．05）,且TNF—α、IL-6、IL-8水平随着胃癌临床病理分期的增加而升高（P〈0．05）。肿瘤根治手术后患者血清TNF—α、IL-6、IL-8水平较术前明显降低（P〈0．05）;良性组血清TNF—α、IL-6、IL-8水平与正常组近似（P〉0．05）。结论胃癌患者血清TNF—α、IL-6、IL-8水平增高;检测胃癌患者血清TNF—α、IL-6、IL-8有助于病情判断和估计预后。     

肝包虫病患者血清中IL-6和TNF-α水平的研究

为了探讨肝包虫病患血清白细胞介素６（ＩＬ－６）和肿瘤坏死因子α（ＴＮＦ－α）水平及其与肝包虫病的关系，应用ＥＬＩＳＡ法检查４２例正常人，２７例肝包虫病血清ＴＮＦ－α水平，其中２０例病人同时检测ＩＬ－６水平，结果显示肝包虫病患血清ＩＬ－６水平为０．１６２６±０．１００６ｎｇ／ｍｌ，显高于正常人０．０１９±０．０１６８ｎｇ／ｍｌ（Ｐ〈０．００１），ＴＮＦ－α水平为８．９９４６±５．３１１２ｎｇ／     

心力衰竭患者血清中TNF-α,IL-1及IL-6的变化及培哚普利对其影响

目的 :探讨心力衰竭 （CHF）患者血清中 TNF-α,IL-1及 IL -6的变化及培哚普利对其水平的影响。方法 :采用放射免疫方法检测 42例服用培哚普利的 CHF患者、42例常规治疗 CHF患者治疗前后及 3 0例健康人血清中TNF-α,IL-1及 IL-6的水平。结果 :184例 CHF患者较健康人血清中 TNF-α,IL-1及 IL-6显著增高 （P<0 .0 1） ,且随着心功能损害程度加重而升高。 2培哚普利组与常规治疗组治疗前后血清中 TNF-α,IL -1及 IL -6水平有显著性差异 （P<0 .0 1） ,且培哚普利组较常规治疗组治疗后血清中 TNF-α,IL -1及 IL -6降低更为明显。结论 :CHF患者TNF-α,IL-1及 IL-6水平与心功能状态密切相关。培哚普利比常规治疗具有较明显降低 TNF-α,IL-1及 IL-6的水平的作用 ,可减缓心脏损伤的进程 ,达到保护和改善 CHF患者的心功能     

心力衰竭患者血清白细胞介素10和肿瘤坏死因子α的变化及意义

目的　探讨白细胞介素 10 (IL- 10 )和肿瘤坏死因子 α(TNF- α)在充血性心力衰竭 (CHF)中的作用和地位。方法　采用双抗体夹心 ABC- EL ISA法 ,测定 4 3例不同病因和心功能的 CHF患者和 16例正常对照组受试者血清IL - 10和 TNF-α浓度。结果　与对照组比 ,CHF患者血清 IL - 10浓度无显著性变化 (P>0 .0 5 ) ,并且不同心功能分级之间也无显著性差异 (P>0 .0 5 )。而血清 TNF-α浓度在 CHF组显著升高 (P<0 .0 1) ,且随着心功能分级增加 ,TNF-α浓度呈进行性增加 (P<0 .0 5 )。相关分析显示 IL - 10与 TNF-α、心功能分级及 6 m in步行距离均无相关性 (P>0 .0 5 ) ,与心力衰竭病程显著性正相关 (相关系数为 0 .33,P<0 .0 5 )。TNF- α与 6 m in步行距离及心功能分级有相关性 (相关系数分别为 - 0 .39,0 .6 4 ,P<0 .0 5 )。结论　心力衰竭时炎性细胞因子增加 ,抗炎性细胞因子不增加 ,细胞因子网络平衡紊乱可能参与 CHF的发生、发展。     

Increased expression of tumor necrosis factor-alpha converting enzyme and tumor necrosis factor-alpha in peripheral blood mononuclear cells in patients with advanced congestive heart failure

BACKGROUND: Tumor necrosis factor-alpha converting enzyme (TACE) has recently been identified as a metalloproteinase-disintegrin, which converts pro-tumor necrosis factor-alpha (TNF-alpha) to the mature form, and is an important mediator in the pathogenesis of CHF. AIMS: In order to establish the importance of TACE in the regulation of TNF-alpha synthesis in peripheral blood mononuclear cells (PBMC), we analyzed mRNAs and protein-positive cells of both TACE and TNF-alpha in PBMC obtained from patients with congestive heart failure (CHF). METHODS AND RESULTS: PBMC were obtained from 46 patients with CHF and 22 controls. PBMC were activated by phorbol 12-myristate 13-acetate and ionomycin and assessed for TACE and TNF-alpha mRNAs by real-time RT-PCR, intracellular TACE and TNF-alpha levels by flow cytometry, and TNF-alpha secretion by supernatant ELISA. Levels of TACE and TNF-alpha mRNAs, intracellular TACE and TNF-alpha, and supernatant TNF-alpha were higher in CHF than in controls (P<0.001). There was a positive correlation between TACE and TNF-alpha levels in CHF patients (mRNA: r=0.60, P<0.001, intracellular protein levels: r=0.76, P<0.001). When the CHF group was divided into two subgroups by NYHA functional class (I and II vs. III and IV), levels of TACE and TNF-alpha were significantly higher in severe CHF patients (NYHA III or IV) than in mild CHF patients (NYHA I or II) (mRNA: P<0.001; intracellular protein levels: P<0.001). CONCLUSION: These results demonstrate that in patients with CHF, and especially those with severe CHF, TACE expression in PBMC increases with TNF-alpha expression. These observations suggest that TACE in PBMC is an important regulator of TNF-alpha maturation, meaning that TACE may be a potential target for the inhibition of cellular TNF-alpha production in CHF.     

心力衰竭患者血浆细胞因子的变化及其临床意义

目的　探讨充血性心力衰竭 (心衰 ,CHF)患者血中肿瘤坏死因子 α(TNF α)和白细胞介素 6(IL 6)的变化及其临床意义。方法　双抗体夹心ELISA法测定 12 2例CHF患者及 3 0例健康人血浆中TNF α和IL 6的浓度。超声心动图测量左心室射血分数及左心室舒张末期内径 ,X线胸片测心胸比。结果　CHF患者血浆中TNF α水平明显高于对照组 (P <0 .0 5 ) ,且随着心衰程度的加重 ,TNF α水平呈进行性增高 ;IL 6水平仅在心功能Ⅲ级、Ⅳ级组中明显高于对照组 (P <0 .0 5 )。TNF α、IL 6与左心室射血分数呈负相关 (r =-0 .5 13 ,r =-0 .45 3 ,P <0 .0 1) ,与心胸比呈正相关 (r =0 .5 0 1,r =0 .43 8,P <0 .0 1) ;与左心室舒张末期内径呈正相关 (r =0 .3 42 ,r =0 .3 0 4,P<0 .0 1)。结论　CHF患者TNF α和IL 6升高可能是心功能恶化的免疫学标志之一 ,提示炎症机制参与心力衰竭的进程     

氯沙坦对心力衰竭患者肿瘤坏死因子α和血管内皮依赖性舒张功能的影响

目的　观察氯沙坦对慢性心力衰竭 (chronicheartfailure ,CHF)患者肿瘤坏死因子α(TNF α)与血管内皮依赖性舒张功能 (endothelialdependentdiastolicfunction ,EDD)的影响。 方法测定 4 9例CHF患者 (CHF组 )和 38例无慢性心力衰竭患者 (无CHF组 )TNF α水平。 4 9例CHF患者随机分为氯沙坦组和常规治疗组。治疗前和治疗 4周后测定TNF α水平及用彩色多普勒血流仪测定肱动脉内径和反应性充血后的内径。结果　CHF组TNF α水平明显高于无CHF组 [( 10 7 4±4 7 2 )比 ( 76 2± 35 4 )ng/L ,P <0 0 1]。治疗 4周后 ,氯沙坦组TNF α水平比治疗前明显降低[( 10 8 5± 12 1)比 ( 91 3± 11 4 )ng/L ,P <0 0 5 ];而反应性充血后血管内径及其变化百分比明显升高 [( 4 9± 8 4 )比 ( 5 5± 7 7)mm ,P <0 0 5 ;( 2 9 2± 4 2 )比 ( 38 9± 5 9) % ,P <0 0 5 ];氯沙坦组的TNF α水平与反应性充血后血管内径及其变化百分比呈负相关 (r =- 0 5 2 ,P <0 0 5 ;r =- 0 6 4 ,P <0 0 5 )。结论　慢性心力衰竭患者的血管内皮功能受损 ,TNF α是引起这一损害的主要因素 ,氯沙坦治疗不仅可以控制心力衰竭症状 ,而且可以有效地改善血管内皮功能     

The changes of circulating tumor necrosis factor levels in patients with congestive heart failure influenced by therapy.

Recent studies suggest that tumor necrosis factor-alpha (TNF-alpha) plays an important role in the pathogenesis of congestive heart failure and that drugs used in the treatment of heart failure have modulation effects on the production of TNF-alpha. To examine an alteration of circulating TNF-alpha concentration in patients with severe chronic heart failure after improving heart function and investigate the influence of agents on circulating TNF-alpha concentrations, we measured the plasma levels of TNF-alpha by enzyme linked immunoabsorbent assay in 31 patients and evaluated their heart functions before and after 72 h of therapy. The results showed that circulating TNF-alpha concentrations significantly decreased after therapy (from 124.36+/-14.85 pg/ml to 93.84+/-13.57 pg/ml, P<0.001). The circulating TNF-alpha concentrations of patients (n = 22) whose heart function was improved one class or more after therapy declined significantly (from 127.51+/-20.78 pg/ml to 91.54+/-18.56 pg/ml, P<0.01) but this situation did not exist in patients (n = 9) whose heart functions had no or little improvement. All patients were divided into three groups according to their management: 'group A' (n = 14) who received milrinone and angiotensin-converting enzyme inhibitors (ACEI), 'group B' (n = 6) who received milrinone but not ACEI and 'group C' (n = 11) who received ACEI and dobutamine but not milrinone. The circulating TNF-alpha concentration of patients in group A significantly declined (from 126.68+/-26.04 pg/ml to 95.92+/-24.79 pg/ml, P<0.01). No statistical significance of change of TNF-alpha concentration was found in patients in group B or group C, although a tendency of decline existed (from 119.92+/-34.72 pg/ml to 84.33+/-30.70 pg/ml and from 123.83+/-19.50 pg/ml to 96.37+/-16.62 pg/ml, respectively). These findings support that decreased plasma TNF-alpha level accompanies the improvement of heart function. This phenomenon may be explained by the special abilities of agents, such as ACEI and milrinone, to inhibit the TNF-alpha production.     

运动训练对心力衰竭患者血液白细胞和肿瘤坏死因子的影响

目的 探讨6min步行运动训练治疗充血性心力衰竭患者的价值;观察同同程度充血性心衰患者白细胞及分类和血浆肿瘤坏死因子（TNF）α水平的变化以及运动训练对其影响。方法 60例Ⅱ、Ⅲ级心功能充血性心衰患者在入院24h之内作6min步行运动实验,记录其行走距离,静息状态和运动后心率,血浆TNFα,血液白细胞总数及分类,然后随机分为两组（训练组32例,对照组28例）,两组均行常规抗心衰药物治疗,但训练组2次行6min步行运动训练,8周后重复检测上述指标。对23例Ⅳ级心功能CHF患者观察了入院时上述血浆细胞因子和白细胞及分类的。结果 Ⅲ、Ⅳ级CHF患者白细胞总数、中性粒细胞和单核细胞百分比较Ⅱ级CHF患者明显增高（P＜0.010;血浆TNFα在Ⅱ、Ⅲ、Ⅳ级CHF中的差异有显著性。运动训练可显著改善CHF症状,减慢增快的心率,增加行走距离。训练组与对照组的差异有显著性（P＜0.05）。运动训练组治疗8周后,CHF患者白细胞、中性粒、单核细胞百分比和血浆TNFα的下降程度较对照组比更显著（P＜0.05）。结论 6min步行运动训练不仅可明显改善心衰患者的TNFα等细胞因子的过度激活,还可改善心衰患者可能存在着的免疫机能缺陷。     

冠心病患者血清白介素-6、白介素-8和肿瘤坏死因子的变化及临床意义

目的探讨冠心病患者血清炎症因子白介素-6（IL-6）、白介素-8（L-8）和肿瘤坏死因子（TNF）含量在冠心病发展过程中的意义。方法测定81例冠心病患者血清炎症因子IL-6、IL-8和TNF含量,观察冠心病患者冠脉狭窄程度与血清IL-6、IL-8及TNF含量变化的关系。结果40例冠脉重度狭窄者血清炎症因子IL-6、IL-8和TNF分别为（163．41±64．18）pg／ml、（0．41±0．11）ng／ml、（2．54±0．63）ng／ral,41例冠脉轻中度狭窄者血清炎症因子IL-6、IL-8和TNF分别为（97．05±27．29）pg／ml、（0．34±0．16）ng／ml、（1．86±0．33）ng／ml,两组间差异存在统计学意义（P〈0．05）。结论血清炎症因子IL-6、IL-8和TNF与冠心病的严重程度有关。冠脉狭窄越明显,炎症因子IL-6、IL-8及TNF含量越高。     

Prognostic value of serum levels of tumor necrosis factor-alpha in patients with heart failure

INTRODUCTION AND OBJECTIVE: Tumor necrosis factor-alpha is an inflammatory cytokine which rises in heart failure and has prognostic value in severe cases. Its value is less established in moderate cases. Our aim was to determine its prognostic value in cases from a community hospital. PATIENTS: We studied 50 patients, average age 59.5 12.3 years, with dilated cardiomyopathy (72% non-ischemic) and moderate heart failure (59% functional class II). METHODS: Patients were evaluated with an echocardiogram and cardiopulmonary treadmill stress test (Naughton), muscular strength measurements (hand dynamometer), blood tumor necrosis factor levels, and an average follow-up of 17.5 9 months (range, 1-29 months). All causes of mortality, cardiac transplantation, and readmissions for heart failure were recorded. RESULTS: Twenty-three patients experienced events. These patients were older (63 +/- 12.7 vs 55.7 +/- 11.4 years; p = 0.042), had a lower peak VO2 (13.7 +/- 3.9 vs 16 +/- 3.3 ml/kg/min; p = 0.035), and higher peak VE/VCO2 and factor levels [41.9 +/- 10.6 vs 33.2 +/- 5.7; p = 0.001 and 4.3 (3.1-7.9) vs 3.3 (2.4-4.3) pg/ml; p = 0.021, respectively]. In the Cox model, the only variable with independent prognostic value was peak VE/VCO2 [HR 1.13 (1.07-1.19); p < 0.001]. The best cutoff point was 34.5 (sensitivity, 86.4%; specificity, 58.3%; p = 0.0007). The cytokine had no independent prognostic value. CONCLUSIONS: Our patients with events were older, had a lower peak VO2, and higher peak VE/VCO2 and serum tumor necrosis factor levels. However, only peak VE/VCO2 had independent prognostic value.