充血性心力衰竭患者细胞因子(TNF-α,ET-1)的变化及静脉注射胺碘酮对其的影响

目的　探讨心力衰竭患者肿瘤坏死因子 - α( TNF- α)、内皮素 ( ET- 1)的变化及静注胺碘酮对其影响。方法　采用放免法检测 16例心力衰竭患者血浆 TNF- α、ET- 1水平 ,并与 2 0例健康对照组测值进行比较。全数病员均予胺碘酮治疗 ,按一次快速注入 15 0 m g,继后按 6 2 5 μg/ min持续静脉滴注 4 h共 15 0 m g方法给药 ,比较静注胺碘酮对其的影响。结果　心力衰竭患者 ET- 1测值与对照组间存在显著性差异 ( P<0 .0 5 ) ,TNF-α水平无显著性差异 ( P>0 .0 5 ) ;静注胺碘酮 30 0 mg后即刻 TNF-α下降显著 ( P<0 .0 1) ,ET- 1测值亦有下降 ,但统计学处理无显著性差异( P>0 .0 5 )。结论　 ET- 1、TNF-α的释放量增加对心力衰竭进程具有促进作用。心力衰竭患者静注胺碘酮为一安全的治疗方法 ,在一定范围内可作为心力衰竭患者抗心律失常的一线紧急用药。

The study of cytokine (TNF-α,ET-1) in congestive heart failure and their changes after intravenous amiodarone

Objective To explore the cytokine (TNF-α,ET-1) in congestive heart failure and their changes after intravenous amiodarone. Methods The blood levels of TNF-α,ET-1 from 16 patients with congestive heart failure were tested with radioimmunoassay. All data were Compared with normal average of 20 healthy adults in our laboratory. All patients were treated by intravenous amiodarone. After the bolus administration (150mg), the amiodarone therapy continued for 4 hours in 625μg/min. Results The abnormalities of ET-1 were apparent (P<0.05), but the difference of TNF-α was not significant statistically (P>0.05). Just after intravenous amiodarone 300mg, TNF-α decreased with significant difference (P<0.01). ET-1 decreased, but not significant statistically (P>0.05). Conclusion Pathologic course of CHF was promoted by increase of ET-1 and TNF-α in blood levels. Intravenous amiodarone in the CHF patients was safe, and seemed to be an emergency antiarrhythmic medicine for the choiced CHF patients.