甲状腺素对老年慢性心力衰竭患者外周血淋巴细胞β受体基因表达的影响  

Effects of thyroxine on β-adrenoceptors expression of peripheral lymphocyte in elderly patients with congestive heart failure

作　　者：赵阳[1] 卢新政 李新华[1] 侯麦花[3] 黄峻 

机构地区：[1]郑州大学第五附属医院老干部科,河南郑州450052 [2]南京医科大学第一附属医院心内科,江苏南京 [3]南京医科大学第一附属医院皮肤科,江苏南京

出　　处：《中华老年医学杂志》2008年第6期424-427,共4页Chinese Journal of Geriatrics

基　　金：基金项目：江苏省自然科学基金（BK2001161）;郑州铁路局科委（00w29）

摘　　要：目的观察补充甲状腺素对老年慢性心力衰竭（CHF）患者外周血淋巴细胞β肾上腺素能受体（p受体）密度及其β1肾上腺素能受体（β1受体）基因表达的作用，并评价此疗法的安全性。方法42例扩张型心肌病和缺血性心肌病所致的老年CHF患者，随机分为常规治疗组和联合治疗组，联合治疗组在常规治疗基础上加服左甲状腺素钠片（优甲乐，德国Meck药业产品），初始量12.5μg／d，1周后逐渐增加剂量，维持在25-100μg／d。治疗前、治疗后1个月分别测定血清甲状腺素水平、同位素放射配基法测定外周血淋巴细胞β受体密度、逆转录聚合酶链反应法测定外周血淋巴细胞β1受体基因表达水平，并与健康人对照比较。结果（1）常规治疗组、联合治疗组外周血淋巴细胞β受体密度分别为（51．3±5．4）和（52．3±5．2）fmol／10^5 cells，β1基因表达水平低于健康对照组的（69．6±4．2）fmol／10^6 cells；（2）左甲状腺素钠片可上调外周血淋巴细胞β受体密度[两组分别为（51．6±3．4）和（58．3±3．7）fmol／10^6 cells]；（3）小剂量甲状腺素增加CHF患者外周血淋巴细胞β1受体基因表达水平。结论补充小剂量甲状腺素，可增加CHF患者外周血淋巴细胞β受体密度及其β1受体基因表达。Objective To determine whether the supplementation of thyroid hormone （TH） improves β-adrenoceptors （β-AR） density and expression of peripheral blood lymphocyte in elderly patients with chronic heart failure （CHF）. Methods A total of 42 elderly patients with advanced CHF（NYHA class Ⅲ or Ⅳ） due to dilated cardiomyopathy （DCM） or ischemic cardiomyopathy （ICM） were randomly divided into a treatment group and a control group. Low-dose L-thyroxine （L- T50） was added to the treatment group, both groups had routine anti-heart-failure treatment. Before and after 1 month of treatment, ^125 I-Pindolol radioligand binding assay was used to measure β-AR in peripheral lymphocytes. Reverse-transcriptase polymerase chain reaction （RT-PCR） was used to measure β-AR expression in peripheral lymphocytes. Results The density and expression of β-AR of lymphocytes in patients with CHF due to ICM or DCM were lower than those in normal health people, and the serum TH level in patients with CHF was lower than that in normal health people. The L-T4 administration induced an up-regulation of β-AR density and expression in peripheral lymphocytes. Conclusions Thyroxine administration induces an up-regulation of β-AR density and expression in peripharal lymphocytes.

关 键 词：甲状腺激素类 心力衰竭 充血性 受体 肾上腺素能 淋巴细胞 

分 类 号：R686[医药卫生—骨科学]