老年心力衰竭患者血清炎性细胞因子与心功能的关系

Correlation of serum inflammatory cytokines levels with cardiac function in elderly patients with heart failure

关键词:  心力衰竭  老年人  炎性细胞因子

Key words:  heart failure  elderly  inflammatory cytokines

摘要:

目的探讨老年心力衰竭（heartfailure，HF）患者炎性细胞因子变化及其与心功能之间的关系。方法应用ELISA法测定92例老年HF患者（HF组）及55例健康老年人（对照组）的血清TNF-α、IL-6、sTNFBI、IL-10水平，同时采用超声心动图测定左心室舒张末期内径（1eftventricularend．diastolicdiameter．LVEDD）和左心室射血分数（1eftventricularejectionfration，LVEF）。结果与对照组相比，HF患者血清TNF-α、IL-6、sTNFBI、IL-10水平及TNF-α/sTNFRI、IL-6/IL-10明显升高，且随着心功能的分级的增加逐渐升高（P＜0．05）；老年HF患者血清TNF-α、IL-6水平与LVEF呈负相关（P＜0.05），与LVEDD呈显著正相关（P＜0.05）。结论老年HF患者促炎性细胞因子与抗爽性细胞因子的平衡偏移于炎性方向，促炎性性细胞因子与心功能状态密切相关。

Abstract:

Objective To investigate the relationship between serum TNF-α, sTNFRI, IL-6, IL-10 levels and cardiac function in elderly patients with heart failure. Methods The serum levels of TNF-α, sTNFRI, IL-6 and IL-10 were determined by ELISA in 92 elderly patients with heart failure and 55 healthy elderly subjects （control group）. The left ventricular end-diastolic diameter （LVEDD） and left ventricular ejection fraction （LVEF） were measured by color Doppler ultrasonography, and the cardiac function was scored with New York Heart Association （NYHA） classification. Results Compared to controls, the serum levels of TNF-α, sTNFRI, IL-6, and IL-10 in elderly patients with heart failure were significantly elevated （P＜0.05）, and increased with upgrading NYHA classification of heart failure （P＜0.05）. The ratio of TNFα/sTNFRI and IL-6/IL-10 in patients were significantly higher than those in controls （P＜0.05） and increased with upgrading NYHA classification （P＜0.05 ）. Serum levels of TNF-α and IL-6 in heart failure patients were positively correlated with LVEDD and negatively correlated with LVEF. Conclusion The serum levels of pro-inflammatory cytokines are closely correlated with cardiac function in elderly patients with heart failure.