摘要
目的观察高原地区（海拔2260～3500m）慢性肺心病右心衰竭患者血浆炎症细胞因子与内皮功能水平的变化及意义。方法278例高原地区慢性肺心病心力衰竭患者和48例正常对照组分别测定肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）、白介素-6（interleukin-6，IL-6）、内皮素（endothelin-1，ET-1）及肺动脉收缩压（PASP）、心功能参数。结果肺心病右心衰竭患者与对照组比较，TNF—α升高，IL-6升高，ET-1升高，LVEF、RVEF降低，PASP升高，肺心病心力衰竭患者TNF-α、IL-6、ET-1与LVEF、RVEF呈显著负相关（P〈0．05或P〈0．01），与PASP呈显著正相关（P〈0．01）。肺心病右心衰竭患者TNF—α、IL-6与ET—1呈显著正相关（P〈0．01）。结论炎症细胞因子TNF—α、IL-6和内皮素ET-1与高原地区慢性肺心病右心衰竭病情严重程度密切相关，细胞因子网络调控和内皮功能紊乱可能参与了高原地区慢性肺心病心力衰竭的发生、发展。
Objective To investigate the changes and clinical significance of the plasma cytokines and endothelium function in patients with chronic pulmonary heart failure disease at high altitude area. Methods Plasma levels of tumor necrosisfactor - alpha（TNF - α） ,interleukin - 6 （IL- 6） , endothelin- 1 （ET- 1 ） were measured in 278 chronic pulmonary heart patients with various degrees of heart failure and in 48 healthy controls. Left ventricular ejection fraction （LVEF） , Right ventricular ejection fraction （RVEF） and Pul- monary （PASP） were examined with echocardiography. Results Plasma levels of TNF - α, IL - 6, ET - 1 were elevated in patients of functional classes Ⅱ to Ⅳ as compared with age - matched control subjects and were progressively elvated with the decreasing functional status of the patients. The levels of TNF - α, IL - 6 , ET - I respectively were positively correlated with PASP but negtively correlated with LVEF and RVEF （P 〈0.05 or 0.01 ）. The levels of ET- 1 were positively correlated with TNF- α and IL- 6 （P 〈 0.01 ）. Conclusion There was significant correlation between the plasma levels of cytokines and endothelin - 1 and the severity in patients with chronic pul- monary heart failure disease at high altitude area. The dysregulated cytokine network and endothelium function may be involved in the development and progression of chronic pulmonary heart failure disease.
出处
《医学研究杂志》
2010年第3期86-88,共3页
Journal of Medical Research
