A型行为者外周血单核细胞Toll样受体4及白细胞介素水平与颈动脉粥样硬化的关系  

Relationship among Toll-like receptor 4 in peripheral blood mononuclear cells,interleulin level and carotid atherosclerosis in individuals with type A behavior pattern

作　　者：宁淑娥[1] 曲鹏[2] 郑美丽[2] 宗大飞[2] 张兴[2] 隋政[2] 

机构地区：[1]海军大连舰艇学院心理咨询中心,辽宁大连116018 [2]大连医科大学附属第二医院心内科

出　　处：《中华高血压杂志》2016年第7期663-669,共7页Chinese Journal of Hypertension

基　　金：国家自然科学基金资助项目(30670836)

摘　　要：目的探讨A型行为得分、外周血单核细胞先天固有免疫系统Toll样受体4(TLR4)和下游炎症因子变化与罹患动脉粥样硬化的关系。方法依据颈动脉超声检查结果将研究对象分为颈动脉粥样硬化组(n=275)和健康对照组(对照组,n=301)。采用明尼苏达多相人格调查表(MMPI)2 A型行为量表评定行为类型(≥11分为A型)。流式细胞术测定外周血CD14^+单核细胞表面TLR4表达,酶联免疫吸附试验(ELISA)法检测血清肾上腺素和去甲肾上腺素、白细胞介素6(IL-6)、白细胞介素18(IL-18)水平。结果颈动脉粥样硬化组A型行为检出率高于对照组(58.68%比24.64%,P<0.01)。颈动脉粥样硬化组血清肾上腺素、去甲肾上腺素水平高于对照组[(17.53±9.98)比(6.83±5.16)μg/L,(863.62±240.58)比(441.17±194.05)ng/L;均P<0.01]。颈动脉粥样硬化组患者单核细胞TLR4表达及IL-6和IL-18水平高于对照组[(14.07±3.54)%比(9.81±3.42)%,(301.87±18.43)比(274.44±13.79)ng/L,(450.39±28.66)比(364.28±34.78)ng/L;均P<0.05]。无论是颈动脉粥样硬化组还是对照组,A型行为者单核细胞TLR4、血清IL-6和IL-18、肾上腺素和去甲肾上腺素水平均高于非A型行为者。多因素Logistic回归分析发现:男性、年龄、高血压、心血管病家族史、A型行为、敌意得分、TLR4表达、血清IL-6和IL-18水平是罹患颈动脉粥样硬化的独立影响因素。结论颈动脉粥样硬化患者交感神经活化程度高于健康人;A型行为者交感神经活化程度、单核细胞TLR4蛋白表达及血清炎症水平高于非A型行为者;A型行为、单核细胞TLR4蛋白表达及血清炎症水平与罹患颈动脉粥样硬化存在相关性。Objective To explore the relationship between Toll-like receptor 4（ TLR4） in peripheral blood mononuclear cell,cytokine level and carotid atherosclerosis in persons with type A behavior pattern（ TABP）. Methods According to the results of carotid artery ultrasound examination,the subjects were divided into carotid atherosclerosis group（ n = 275）and non-carotid atherosclerosis group（ control group,n = 301）. TABP was defined as score of Minnesota multiphase personality inventory（ MMPI） 2 A subscale greater than or equal to 11 points. TLR4 protein was measured by flow cytometry,and the levels of interleulin（ IL） 6 and IL-18,epinephrine（ E） and norepinephrine（ NE） were measured by enzymelinked immunosorbnent assay（ ELISA）. Results The propotion of TABP in subjects with carotid atherosclerosis was higher than that in control group（ 58. 68% vs 24. 64%,P〈 0. 01）. The expression of TLR4 protein in peripheral blood mononuclear cell,IL-6 and IL-18,E and NE levels in serum were significantly higher in carotid atherosclerosis subjects than in control group [（ 14. 07 ± 3. 54） % vs（ 9. 81 ± 3. 42） %,（ 301. 87 ± 18. 43） vs（ 274. 44 ± 13. 79） ng / L,（ 450. 39± 28. 66） vs（ 364. 28 ± 34. 78） ng / L,（ 17. 53 ± 9. 98） vs（ 6. 83 ± 5. 16） μg / L,（ 863. 62 ± 240. 58） vs（ 441. 17 ±194. 05） ng / L,all P 〈0. 05]. Both in subjects with and without carotid atherosclerosis,those with TABP had significantly higher expression of TLR4 protein in peripheral blood mononuclear cell,and higher serum IL-6,IL-18,E and NE levels than non-TABP subjects. Multivariate Logistic regression analysis showed that male,age,hypertension,history of cardiovascular disease,TABP,scores of hostility dimension,the expression of TLR4 protein,IL-6 and IL-18 in peripheral blood mononuclear cell were influential factors for carotid atherosclerosis. Conclusion Sympathetic nervous system（ SNS） in carotid atherosclerosis subjects was more highly activated than in healthy volunt

关 键 词：A型行为 儿茶酚胺 TOLL样受体4 白细胞介素 颈动脉粥样硬化 

分 类 号：R543.4[医药卫生—心血管疾病]