心力衰竭的抗炎性因子免疫调节治疗-幻灯ppt课件

1、心力衰竭缺血性心肌病缺血性心肌病心肌炎心肌炎,心肌病心肌病 容量负荷过重容量负荷过重 压力负荷过重代谢性心肌病代谢性心肌病细胞因子细胞因子 心室重构细胞因子细胞因子 参与参与 诱导型一氧化氮合酶(iNOs)表达心肌细胞内产生大量NO细胞内环磷酸鸟苷细胞内环磷酸鸟苷( cGMP)抑制心肌细胞钙离子内流激活型磷酸二酯酶降低心肌细胞内环磷酸腺苷程度三磷酸腺苷(ATP) 合成缺乏TNF- 心肌收缩性减退心肌收缩性减退 n除了直接作用于心肌细胞外除了直接作用于心肌细胞外, TNF- 还可经过促进还可经过促进IL- 1, IL- 6, n 干扰素等多种具有负性变力效应的细胞因子的表达与释放产生间接干扰素等

2、多种具有负性变力效应的细胞因子的表达与释放产生间接n 的负性变力效应的负性变力效应,致心室扩张、间质纤维化、心功能减退恶化。致心室扩张、间质纤维化、心功能减退恶化。Tsutamoto T, Hisanaga T,Wada A , et al. Interleukin-6 spillover in theperipheral circulation increases with the severity of heart failure, and thehigh plasma level of interleukin-6 is an important prognostic predictor

3、inPatients with congestive heart failure J . Am Co ll Cardio l, 2019, 31 (2) :3912398加强免疫效应加强免疫效应因子激活因子激活免疫抑制效应免疫抑制效应因子降低因子降低免疫系统免疫系统平衡突破平衡突破TNF- 、IL-6 等等转化生转化生长因子长因子-B和和IL-10等等 Effects of 6 months of pentoxifylline or placebo on ejection fraction. *P0.05, placebo vs pentoxifylline, change from base

4、line to 6 months; ANCOVA to correct for baseline differences.752 Circulation February 17, 2019Sliva K, Woodiwiss A, Kone VN, et al. Therapy of ischemic cardiomyopathywith the immunomolulating agent pentoxifylline: resultsof a randomized study J . Circulation, 2019, 109: 750- 755.Sliva K, Woodiwiss A

5、, Kone VN, et al. Therapy of ischemic cardiomyopathywith the immunomolulating agent pentoxifylline: resultsof a randomized study J . Circulation, 2019, 109: 750- 755.LVEF as assessed by ECG-synchronized gated radionuclide ventriculography at rest in 39 CHF patients before and after 6 months of treatment with IVIG (n=19) or placebo (n=20). MeanSEM values are given. In patients with particul