论文部分内容阅读
目的探讨己酮可可碱(pentoxifylline,PTX)对慢性心力衰竭患者外周血辅助性T淋巴细胞(Th)Th1/Th2细胞因子免疫调节及B型利钠肽(B-type natriuretic peptide,BNP)的影响。方法心力衰竭患者分为己酮可可碱治疗组(PTX组,17例)和常规治疗组(常规组,18例),采用流式细胞分析法,检测35例心力衰竭患者和正常对照者(10例)外周血CD4+Th1型细胞因子干扰素-γ(IFN-γ)和Th2型细胞因子白介素-10(IL-10)细胞百分率的变化;采用酶联免疫吸附法(ELISA)分别测定心力衰竭患者外周血肿瘤坏死因子-α(TNF-α)、IL-10及B型利钠肽的水平;应用彩色多普勒超声诊断仪测定左心室射血分数(LVEF)的变化。结果心力衰竭患者基线水平CD4+Th1(IFN-γ)细胞百分率及Th1/Th2比值显著高于正常对照组[(18.42±5.63)vs(6.69±1.39),P<0.01];(1.58±0.78)vs(0.17±0.04),P<0.01),心力衰竭患者治疗1个月后,PTX组与常规组比较,PTX组CD4+Th1(IFN-γ)细胞百分率[(11.97±2.75)vs(15.20±4.13)]和Th1/Th2比值[(0.82±0.31)vs(1.33±0.40)]显著降低(P<0.01),外周血TNF-α及B型利钠肽水平显著降低[(80.42±43.70)pg/mlvs(114.31±46.38)pg/ml,P<0.05;(247.94±105.33)ng/Lvs(335.12±106.57)ng/L,P<0.01],IL-10水平轻度升高[(9.81±3.13)pg/mlvs(8.11±2.66)pg/ml,P>0.05];左心室射血分数显著提高[(36.54±5.21)vs(30.76±4.80),P<0.01]。结论心力衰竭患者在常规治疗的基础上应用己酮可可碱,左心功能得到改善,可能与己酮可可碱对心力衰竭患者Th1/Th2细胞失衡起到免疫调节作用,并通过免疫调节影响炎性细胞因子的激活与分泌有关。
Objective To investigate the effects of pentoxifylline (PTX) on the immune regulation of Th1 / Th2 cytokines and B-type natriuretic peptide (BNP) in peripheral blood of patients with chronic heart failure . Methods The patients with heart failure were divided into pentoxifylline treatment group (PTX group, n = 17) and conventional treatment group (n = 18). Flow cytometry was used to detect 35 cases of heart failure patients and normal controls The changes of the percentages of CD4 + Th1 type cytokines interferon-γ (IFN-γ) and Th2 type cytokines interleukin-10 (IL-10) in peripheral blood were detected by enzyme linked immunosorbent assay (ELISA) The levels of tumor necrosis factor-α (TNF-α), IL-10 and B-type natriuretic peptide in peripheral blood were measured. The changes of left ventricular ejection fraction (LVEF) were measured by color Doppler sonography. Results The percentage of CD4 + Th1 (IFN-γ) cells and the Th1 / Th2 ratio in patients with heart failure were significantly higher than those in the control group [(18.42 ± 5.63) vs 6.69 ± 1.39, P <0.01] the percentage of CD4 + Th1 (IFN-γ) cells in PTX group [(11.97 ± 2.75) vs (15.20 ± 4.13) and Th1 / Th2 ratio [(0.82 ± 0.31) vs (1.33 ± 0.40) vs (80.42 ± 43.70) pg /mlvs(114.31 ± 46.38)pg/ml,P<0.05;(247.94 ± 105.33)ng/Lvs(335.12 ± 106.57)ng/L,P<0.01], the level of IL-10 increased slightly ([9.81 ± 3.13 ) (p <0.01). The left ventricular ejection fraction increased significantly (36.54 ± 5.21 vs 30.76 ± 4.80, P <0.01). Conclusion In patients with heart failure, pentoxifylline is used on the basis of routine treatment, and left ventricular function is improved. It may play an immunomodulatory role in the imbalance of Th1 / Th2 cells with pentoxifylline in patients with congestive heart failure, and may affect inflammation through immune regulation Activation and secretion of cytokines.