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目的:观察成人先天性心脏病(简称先心病)介入封堵术前后炎症细胞因子的变化,探讨介入封堵术对成人先心病免疫激活状况的影响。方法:选择55例成人先心病患者(先心病组),其中40例行介入封堵术;30例年龄及性别与之相匹配的正常体检成人作为对照组。用酶联免疫吸附法(ELISA),检测对照组及先心病组介入封堵术前和术后3、6个月血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)及IL-10的动态变化。结果:先心病组术前血清TNF-α、IL-6及IL-10显著高于对照组(均P<0.01),TNF-α/IL-10升高更明显(P<0.01);先心病随着心功能级别增高,血清TNF-α及IL-6水平明显增高(均P<0.05),IL-10水平明显降低(P<0.05);介入封堵术后3个月血清所测细胞因子均明显降低(均P<0.01),至6个月恢复至正常水平。结论:成人先心病存在着一定程度的免疫激活,致使炎性细胞因子增加和抗炎性细胞因子相对不足,并与疾病的严重性关系密切。介入封堵术后免疫系统逐渐恢复平衡。
Objective: To observe the changes of inflammatory cytokines in adults with congenital heart disease (CHD) before and after the interventional closure, and to investigate the influence of interventional closure on the immune activation of CHD. Methods: Fifty-five adults with congenital heart disease (CHD) were enrolled in this study. Forty of them were treated with occlusion and occlusion, and 30 healthy adults with matched age and gender were selected as the control group. Serum levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were measured by enzyme-linked immunosorbent assay (ELISA) 6) and the dynamic changes of IL-10. Results: Preoperative serum levels of TNF-α, IL-6 and IL-10 in CHD group were significantly higher than those in control group (all P <0.01), while TNF-α / IL- Serum levels of TNF-α and IL-6 were significantly increased (P <0.05) and IL-10 levels were significantly decreased as the level of cardiac function increased (P <0.05). Serum levels of cytokines Were significantly lower (both P <0.01), to 6 months returned to normal levels. CONCLUSION: There is a certain degree of immune activation in CHD, which leads to the increase of inflammatory cytokines and the relative lack of anti-inflammatory cytokines, which is closely related to the severity of the disease. Interventional closure of the immune system gradually restored balance.