Salomon Piotr, Halawa Bogumił, Karolko Bozena
Katedra i Klinika Kardiologii AM we Wrocławiu.
Pol Arch Med Wewn. 2003 Feb;109(2):149-55.
Recent studies showed higher plasma levels of several cytokines, such as interleukines or tumour necrosis factor in patients with congestive heart failure. Cytokines play a very important role in pathogenesis of congestive heart failure, because they impair contractility of heart muscle and cause damage of endothelium and myocytes due to their proinflammatory effects. One of the treatment modalities of heart failure might be administration of drugs inhibiting production of cytokines. The study was undertaken to evaluate whether beneficial effects of amlodipine in congestive heart failure are due to inhibition of synthesis of cytokines. The plasma levels of interleukine 6 (IL-6), tumour necrosis factor (TNF-alpha), neuropeptide Y (NPY) and endothelin-1 (ET-1) were determined in patients with congestive heart failure (NYHA II and III) before and after 30 days of treatment with amlodipine. 40 patients with congestive heart failure (CHF) treated in the Department of Cardiology of Medical University in Wrocław participated in this study. In all patients CHF developed in the course of ischaemic heart disease and coexisting hypertension. Patients were divided into 2 groups dependingly on the NYHA classification. The first group consisted of 24 patients in II NYHA class, the other one--of 16 patients in III NYHA class. At 8 am, on the second day after admission and before treatment with amlodipine blood samples were taken from examined patients to determine plasma levels of IL-6, TNF-alpha, NPY and ET-1. Then patients were administered amlodipine at the dose of 5-10 mg per day. The next blood samples were taken on 5th and 30th day of treatment. Plasma levels of TNF-alpha, IL-6, NPY and ET-1 were estimated with radioimmunoassay using Medgerix kits. Our findings showed that plasma levels of TNF-alpha, IL-6, NPY and ET-1 in patients with CHF are increased. 30-days treatment with amlodipine caused significant decrease of TNF-alpha and IL-6 levels, but did not influence the plasma levels of NPY and ET-1. Amlodipine causes improvement of circulatory efficiency assessed according to NYHA classification. Treatment with amlodipine may be an additional way of therapy in CHF.
近期研究表明，充血性心力衰竭患者体内几种细胞因子的血浆水平较高，如白细胞介素或肿瘤坏死因子。细胞因子在充血性心力衰竭的发病机制中起着非常重要的作用，因为它们会损害心肌收缩力，并因其促炎作用导致内皮细胞和心肌细胞受损。心力衰竭的治疗方法之一可能是给予抑制细胞因子产生的药物。本研究旨在评估氨氯地平在充血性心力衰竭中的有益作用是否归因于对细胞因子合成的抑制。在充血性心力衰竭（纽约心脏协会II级和III级）患者中，在接受氨氯地平治疗30天前后，测定白细胞介素6（IL-6）、肿瘤坏死因子（TNF-α）、神经肽Y（NPY）和内皮素-1（ET-1）的血浆水平。弗罗茨瓦夫医科大学心脏病学系治疗的40例充血性心力衰竭（CHF）患者参与了本研究。所有患者的CHF均在缺血性心脏病和并存高血压的过程中发生。根据纽约心脏协会分类，患者分为2组。第一组由24例纽约心脏协会II级患者组成，另一组由16例纽约心脏协会III级患者组成。入院后第二天上午8点，在接受氨氯地平治疗前，从受试患者采集血样，以测定IL-6、TNF-α、NPY和ET-1的血浆水平。然后患者每天服用5-10毫克剂量的氨氯地平。在治疗的第5天和第30天采集下一次血样。使用Medgerix试剂盒通过放射免疫分析法估计TNF-α、IL-6、NPY和ET-1的血浆水平。我们的研究结果表明，CHF患者的TNF-α、IL-6、NPY和ET-1血浆水平升高。氨氯地平治疗30天导致TNF-α和IL-6水平显著降低，但不影响NPY和ET-1的血浆水平。氨氯地平可改善根据纽约心脏协会分类评估的循环效率。氨氯地平治疗可能是CHF的一种额外治疗方式。
