TLR2和TLR4与老年慢性左心衰关系的研究  

Study on relationship between chronic left heart failure and TLR2 and TLR4 in elderly patients

作　　者：胡有东[1] 李侠[1] 程蕴琳[2] 郭燕[1] 许诚[1] 韩雪花[1] 

机构地区：[1]徐州医学院淮安附属医院老年病科,江苏省淮安市223002 [2]南京医科大学第一附属医院老年医学科,江苏省南京市210029

出　　处：《实用老年医学》2009年第6期426-428,431,共4页Practical Geriatrics

基　　金：淮安市科技局科技项目(HAS04020)

摘　　要：目的探讨Toll样受体2(Toll-like receptor 2,TLR2)和Toll样受体4(Toll-like receptor 4,TLR4)在老年慢性左心衰患者外周血单核细胞表面的表达及其表达的差异在老年慢性左心衰发生发展中的意义。方法根据NYHA心功能分级和左室射血分数(LVEF)将健康对照者和慢性左心衰患者分成对照组(LVEF 50%～70%)、心功能Ⅰ级(LVEF 40%～49%)、Ⅱ级(LVEF 32%～39%)、Ⅲ级(LVEF 27%～31%)和Ⅳ级组(LVEF22%～26%)。采用流式细胞仪检测慢性左心衰患者和健康对照者外周血单核细胞表面TLR2和TLR4的表达。结果与对照组、心功能Ⅰ级、Ⅱ级和Ⅲ级组比较,心功能Ⅳ级组的TLR2和TLR4的水平明显上升(P<0.05)。结论TLR2和TLR4的表达随着心功能分级的升高和LVEF的下降而明显上升。TLR2和TLR4的表达显著上调可能是促进老年慢性左心衰发生发展的机制之一;TLR2和TLR4及其介导的炎症反应与老年慢性左心衰的发生发展有一定的相关性。Objective To explore the expression of Toll-like receptor 2 （TLR2） and Toll-like receptor 4 （TLR4） on peripheral blood mononuclear cells （PBMC） in elderly patients with chronic left heart failure and the significance of TLR2 and TLR4 expression in chronic left heart failure. Methods According to New York heart association （NYHA） classification and left ventricular ejection fraction （LVEF）, the healthy subjects and the patients were divided into five groups： control group（ LVEF 50% -70% ）, class Ⅰgroup（ LVEF 40% - 49% ）, class Ⅱ group（ LVEF 32% -39% ）, class Ⅲ group（ LVEF 27% -31% ） and class Ⅳ group（ LVEF 22% -26% ）. The expression of TLR2 and TLR4 on PBMC of the patients and healthy subjects was measured by flow cytometry. Results The levels of TLR2 and TLR4 of elderly patients with chronic left heart failure were increased significantly in NYHA class Ⅳ group compared with class Ⅰ group, class Ⅱ group, class Ⅲ group and control group. Conclusions The study shows the elevation of TLR2 and TLR4 in advanced phases. The up-regulation of monocyte TLR2 and TLR4 may contribute to the pathophysiology of chronic heart failure in the elderly. It could be related to the role of inflammatory mediation of TLR2 and TLR4.

关 键 词：慢性左心衰 老年人 TOLL样受体2 TOLL样受体4 流式细胞术 

分 类 号：R541.61[医药卫生—心血管疾病]