PPARα、β在高血压房颤患者外周血单核细胞中的表达  

Expression of Peroxisome Proliferator-activated Receptor α and β in Peripheral Blood Mononuclear Cells of Non-vavular Hypertensive Atrial Fibrillation Patients

作　　者：邓小明[1] 罗晓佳[2] 陈晓平[1] 何森[1] 李龙心[1] 万里艳[1] 彭勇[1] 

机构地区：[1]四川大学华西医院心内科,成都610041 [2]成都市第二人民医院心内科,成都610017

出　　处：《四川大学学报（医学版）》2013年第3期383-387,共5页Journal of Sichuan University(Medical Sciences)

基　　金：四川省科技厅支撑项目(No.2009S20194)资助

摘　　要：目的通过研究高血压房颤(h-AF)患者外周血单核细胞过氧化物酶体增殖物激活受体α、β(PPARα、PPARβ)的表达水平,探讨其在房颤发病中的可能作用。方法对103例h-AF患者(其中持续性房颤55例,阵发性房颤48例),以及按照年龄配对选取的50例单纯高血压患者采外周静脉血,采用实时荧光定量PCR方法,测定外周血单核细胞PPARα、PPARβ、肿瘤坏死因子-α(TNF-α)及白细胞介素-6(IL-6)mRNA的表达,酶联免疫吸附法测定血清C反应蛋白(CRP)和白细胞介素-1(IL-1)的水平。结果 PPARαmRNA水平在单纯高血压患者、阵发性h-AF及持续性h-AF中逐渐降低(1.34±0.17、1.09±0.23、0.85±0.22),差异有统计学意义(P均<0.001);TNF-αmRNA、IL-6mRNA、CRP及IL-1逐渐升高,差异有统计学意义(P均<0.001);而PPARβmRNA在各组之间差异无统计学意义。控制混杂因素后,偏相关分析提示左心房直径与CRP、IL-1、IL-6mRNA及TNF-αmRNA呈正相关(P均<0.05);而偏相关分析提示PPARαmRNA与CRP、IL-1、IL-6mRNA及TNF-αmRNA呈负相关,相关系数分别为-0.519、-0.532、-0.491和-0.528(P均<0.05)。结论在高血压房颤患者中,炎症相关指标表达的升高可能与心房重塑有密切的关系,并进而导致房颤的发生发展;而PPARα与上述炎症指标呈负相关,可能在调节房颤发生发展过程中起有益作用。Objecitve To determine the mRNA expressions of PPARα and PPARβ in peripheral blood mononuclear cells of non-vavular hypertensive atrial fibrillation （AF） patients and elucidate its possible role in the pathogenesis of AF. Methods Peripheral blood samples were collected from 103 patients with hypertensive AF （persistent AF： 55, paroxysmal AF： 48） and 50 age-adjusted hypertension patients without AF. The mRNA expressions of PPARα, PPARβ, interleukin-6 （IL-6）, and tumor necrosis factor-α （TNF-a） in monocytes were detected by using a Real time polymerase chain reaction. The concentrations of high sensitive C-reactive protein （CRP） and interleukin-1 （IL-1） were measured by immunoenzymetric method. Results The PPARα mRNA expression level was persistently decreased in hypertensive non-AF group, paroxysmal AF group, and persistent AF group （1.34 ±0. 17, 1.09 ± 0. 23,0. 85 ± 0. 22）, while the difference was statistically significant （P〈0. 001 ; respectively）. TNF-a mRNA, IL-6 mRNA,CRP and IL-1 persistently increased in hypertensive non-AF group, paroxysmal AF group, persistent AF group, also the difference was statistically significant （P 〈0. 001; respectively）. The difference of PPA.Rfl mRNA was not statistically significant between non-AF group, paroxysmal AF group and persistent AF group. Left atrial diameter （LAD） was in positive correlation with CRP, IL-1, IL-6 mRNA and TNF-a mRNA （P〈0. 05）. PPARα mRNA level was in negative correlation with CRP, IL-1, IL-6 mRNA and TNF-a mRNA, the correlation coefficient was - 0.519, - 0. 532, - 0. 491 and - 0. 528, respectively （P〈0.05）. Conclusion In hypertensive patients with AF, increased inflammatory cytokines were associated with atrial remodeling and lead to the development of atrial fibrillation, PPARa was negatively correlated with these inflammatory cytokines and may play a vital role in the process of atrial fibrillation development.

关 键 词：非瓣膜性房颤 高血压 过氧化物酶体增殖激活受体α β炎症因子 

分 类 号：R541.75[医药卫生—心血管疾病]