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目的 :了解炎性与抗炎性细胞因子在充血性心力衰竭 (CHF)过程中的变化及其临床意义。方法 :用双抗体夹心ELISA法测定 12 2例CHF患者及 30例健康人血浆中肿瘤坏死因子 α(TNF α)、白细胞介素 6 (IL 6 )、白细胞介素 10 (IL 10 )的浓度。结果 :①CHF患者血浆中TNF α水平明显高于对照者 (P <0 .0 5或 <0 .0 1) ,且随着心力衰竭程度的加重 ,TNF α水平呈进行性增高 ;CHF患者血浆IL 6及IL 10水平 ,心功能Ⅲ、Ⅳ级者明显高于对照者 (P <0 .0 5或 <0 .0 1) ,而心功能Ⅱ级者与对照者相比差异无显著性意义。②TNF α与IL 6 (r =0 .6 18,P <0 .0 1)、IL 10 (r =0 .5 6 6 ,P <0 .0 1)均呈正相关 ,但TNF α与IL 10的比率 (TNF α/IL 10 )也随着心功能的恶化而升高 ,IL 10的升高与TNF α的升高相比明显不足。结论 :细胞因子的变化与心力衰竭的严重程度密切相关 ,CHF患者血中炎性细胞因子明显升高的同时伴有抗炎性细胞因子升高的相对不足 ,炎性与抗炎性细胞因子之间的平衡失调可能参与了CHF的发生发展
Objective: To investigate the changes and clinical significance of inflammatory and anti-inflammatory cytokines during congestive heart failure (CHF). Methods: The plasma levels of tumor necrosis factor α (TNF α), interleukin 6 (IL 6) and interleukin 10 (IL 10) were measured by double antibody sandwich ELISA in 122 CHF patients and 30 healthy subjects. Results: ① The plasma levels of TNFα in CHF patients were significantly higher than those in controls (P <0.05 or <0.01), and the level of TNFα increased progressively with the severity of heart failure. The levels of plasma IL 6 and IL-10, cardiac function Ⅲ and Ⅳ were significantly higher than those in control (P <0.05 or <0.01), but there was no significant difference in cardiac function grade Ⅱ and control subjects. ②TNF α was positively correlated with IL 6 (r = 0.188, P <0.01), IL 10 (r = 0.666, P <0.01), but TNFα and IL 10 The ratio (TNF [alpha] / IL10) also increases with worsening of cardiac function, and the increase in IL10 is significantly less than the increase in TNFa. CONCLUSION: The changes of cytokines are closely related to the severity of heart failure. The serum levels of inflammatory cytokines in patients with CHF are significantly increased accompanied by the relative insufficiency of anti-inflammatory cytokines. The levels of inflammatory and anti-inflammatory cytokines Balancing disorders may be involved in the occurrence and development of CHF