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目的 :观察小剂量多巴酚丁胺对严重的充血性心力衰竭 (Congestiveheartfailure ,CHF)患者左室射血分数(Leftventricurlarejectionfraction ,LVEF)及肿瘤坏死因子 -α(Tumornecrosisfactore -alpha ,TNF -α)和白细胞介素 - 6 (Interleukin - 6 ,IL - 6 )的水平的影响。方法 :30例心功能正常的心脏病患者和 5 2例CHF患者作为研究对象。 5 2例CHF患者被随机地分为多巴酚丁胺治疗组和对照组。对照组给予卡托普利、利尿剂、洋地黄类和硝酸酯类 ;治疗组在此基础上加用多巴酚丁胺 ,剂量为 2 .5～ 5ug/kg/min ,共 10d。测定左室射血分数、血清TNF -α和IL - 6及其变化。结果 :CHF组血清TNF -α和IL - 6水平明显高于无心衰组 (P <0 .0 0 1)。治疗后两组LVEF均有所提高 ,但多巴酚丁胺组更明显 ,两组比较具有统计学差异 (P <0 .0 5 )。治疗后与治疗前比较 ,对照组血清TNF -α和IL - 6有显著性意义的降低 ,而多巴酚丁胺治疗组无显著性变化。结论 :CHF患者血清TNF -α和IL - 6水平明显增高 ;多巴酚丁胺虽然可以改善临床症状及提高LVEF ,但无改善血清TNF -α和IL - 6的作用。
Objective: To observe the effects of low dose dobutamine on left ventricular ejection fraction (LVEF) and tumor necrosis factor-α (TNF-α) and leukocyte count in patients with severe congestive heart failure (CHF) Interleukin - 6, IL - 6 levels. Methods: Thirty patients with normal heart function and 52 patients with CHF were enrolled in this study. Fifty-two CHF patients were randomized to dobutamine-treated and control groups. The control group was given captopril, diuretics, digitalis and nitrates; the treatment group was given dobutamine at a dose of 2.5 ~ 5ug / kg / min for 10 days. Left ventricular ejection fraction, serum TNF-α and IL-6 levels and their changes were measured. Results: The levels of TNF - α and IL - 6 in CHF group were significantly higher than those in CHF group (P <0.01). After treatment, LVEF increased in both groups, but the more obvious in dobutamine group, the two groups were statistically significant (P <0.05). After treatment, compared with before treatment, serum TNF-α and IL-6 in the control group had a significant decrease, while the dobutamine treatment group had no significant change. Conclusions: Serum levels of TNF - α and IL - 6 are significantly increased in CHF patients. Dobutamine may improve the clinical symptoms and improve LVEF, but not improve the serum levels of TNF - α and IL - 6.