慢性心衰患者炎症细胞因子表达及其与心功能的关系

目的观察慢性心力衰竭（CHF）患者外周血炎症细胞因子白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、纤维蛋白原（FG）、超敏C-反应蛋白（hs—CRP）水平变化及其与心功能状况的关系。方法选择60例CHF患者为病例组，包括冠心病30例、高血压性心脏病14例、心肌病16例（扩张型心肌病10例、肥厚型心肌病6例）。另外选择40例年龄、性别与病例组相匹配的健康受试者作为对照组。所有受试者均测定外周血IL-1β、IL-6、TNF—α、FG、hs—CRP水平和血脂（TC、TG、LDL—C、HDL—C），同时询问吸烟史、高血压病史及糖尿病史。CHF患者评估NYHA心功能分级。结果CHF患者外周血炎症细胞因子IL-1β、IL-6、TNF—α、FG、hs—CRP水平显著高于对照组（P〈0．01）；不同病因心衰患者间IL-1β、IL-6、TNF—α、FG、hs—CRP水平差异无统计学意义（P〉0．05）；不同NYHA心功能分级组间IL-18、IL-6、TNF—α、FG、hs—CRP水平差异存在统计学意义（P〈0．05或P〈0．01）。结论CHF患者外周血炎症细胞因子IL-1β、IL-6、TNF—α、FG、hs—CRP水平显著高于对照组，不同NYHA心功能分级组间IL-1β、IL-6、TNF—α、FG、hs—CRP水平差异存在统计学意义。它们之间可能有相互作用，共同参与CHF的发病机制。

Concentrations of serum cytokines in the patients with chronic heart failure and their relationships with cardiac function status

Objective To investigate the concentrations of serum cytokine interleukin-l-beta （IL-1β）, interleukin-6 （ IL-6 ）, tumor necrosis factor-alpha （TNF-ct）, fibrinogen （ FG ）, high sensitive C -reactive protein （hs-CRP） in the patients with chronic heart failure （CHF） and their relationships with the heart function status. Methods 60 hospitalized patients with CHF in Cardiology of Changhai Hospital from November 2006 to July 2007 were enrolled as patients group. The CHF patients were consisted of 30 patients with coronary artery disease（CAD）, 14 with hypertensive heart disease（HHD）, 16 with cardiomyopathy（CM） （10 dilated cardiomyopathy patients and 6 hypertrophic cardiomyopathy）. 40 healthy subjects matched for the age and sex with the patients group were enrolled as control group. Concentrations of serum IL-1β, IL-6, TNF-α, FG, hs-CRP and lipids （TC, TG, LDL-C, HDL-C） were measured. Age, sex and prior medical histories including hypertension, diabetes mellitus and smoking status were obtained in all subjects. NYHA cardiac functional grading was evaluated in CHF patients. Clinical parameters and the concentrations of serum cytokines were compared statistically between the CHF group and the controls. Results The concentrations of serum IL-1β, IL-6, TNF-α, FG and hs-CRP in CHF group were significantly higher than those in controls（P〈0.01 ）. No differences were found in these serum eytokine levels between different etiologies of CHF patients（P〉0.05）. The concentrations of serum IL-1β, IL-6, TNF-α, FG and hs-CRP in CHF group were significantly different among the groups of different NYHA cardiac functional grading （P〈0.05 or P〈O.01 ）. Conclusion The concentrations of serum IL-1β, IL-6, TNF-α, FG and hs-CRP in CHF group are significantly higher than those in controls, and also significandy different among the groups of different NYHA cardiac functional grading. They may interact and influence each other in the pathogenic mechanism of CHF.