心肌炎患者血清半乳糖凝集素-9白细胞介素-4γ干扰素水平变化及其临床意义  

The changes and clinical significances of serum levels of galectin - 9, IL - 4 and IFN - γ in patients with myocarditis

作　　者：王德国[1] 吴勇[1] 宋骏[2] 张梦莹[3] 钟民[3] 吕坤[3] 

机构地区：[1]皖南医学院附属弋矶山医院老年医学科,安徽芜湖241001 [2]皖南医学院附属弋矶山医院检验科,安徽芜湖241001 [3]皖南医学院附属弋矶山医院中心实验室,安徽芜湖241001

出　　处：《中国急救医学》2017年第5期415-418,共4页Chinese Journal of Critical Care Medicine

基　　金：国家自然科学基金（81200142,81300172,81472017,81670301）;安徽省高校优秀青年人才支持计划重点项目（gxyqZD2016181）

摘　　要：目的观察心肌炎患者血清半乳糖凝集素-9（galectin-9）、白细胞介素-4（IL-4）、1干扰素（IFN-γ）水平改变，探讨其在心肌炎患者诊断及预后中的价值及其临床意义。方法收集2014—01—2016—12间我院诊治的心肌炎患者76例和30例年龄相仿的健康志愿者，根据病程将患者分成心肌炎A组（病程≤30d者49例）和心肌炎B组（病程〉30d27例）；ELISA法检测血清galectin-9、IFN-γ和IL-4。比较心肌炎组与正常对照组血清galectin-9、IFN-1和IL-4的差异。结果与正常对照组比较，心肌炎组血清galectin-9、IFN-1和IL-γ水平均显著升高，心肌炎B组galectin-9、IL-4、IFN-γ/IL-4水平显著低于心肌炎A组，但仍显著高于正常对照组。心肌炎组血galectin-9与IFN-γ、IL-4、IFNγ/IL-4、血清天门冬氨酸氨基转换酶（AST）、肌酸激酶同工敏（CK—MB）、心肌肌钙蛋白1（cTnI）、左心房内径（LVD）呈显著正相关，与发病时间及LVEF呈显著负相关。结论本研究发现，心肌炎患者血清galectin-9水平升高，且galectin-9水平与IFN-1、IL-4、IFN-γ/IL-4呈正相关，提示血清galectin-9对心肌炎诊断及其预后随访有潜在的临床价值。Objective This study aimed to investigate the changes of galectin -9, interleukin-4（ IL- 4） and interferson-γ （IFN -γ） in patients with myocarditis and analyze the clinical significance of these cytokines. Methods Subjects were 93 patients enrolled in our hospital from January of 2014 to December of 2016, 76 with myocarditis, and 30 healthy volunteer adults. Patients with myocarditis were divided into group A （ ≤ 30 days, n = 49 ） and B group （ 〉 30 days, n = 27） according to the course of the disease. Serum concentrations of galectin - 9, IFN - γ and IL - 4 were detected by an enzymelinked immunosorbent assay （ELISA）. In conclusion, serum galectin- 9 could be a new biomarker for patients with myocarditis. Results The levels of serum galectin - 9, IFN -γ and IL - 4 were higher in patients with myocarditis than those in healthy subjects （ P 〈 0.05 ）. The levels of galectin - 9, IL - 4 and IFN - γ/IL - 4 in group B were significantly lower than those in group A, but still significantly higher than those in normal control group （ P 〈 0.05 ）. Serum galectin - 9 was positively correlated with IFN- γ, IL- 4, IFN- γ/IL- 4, AST, CK- MB, cTnI and LVD, and negatively correlated with the time of onset and LVEF in patients with myocarditis. Conclusion This study showed that serum galectin -9 levels increased in patients with myoearditis, and were positively correlated with IFN - γ, IL - 4, IFN - γ/IL - 4, suggesting that serum galectin - 9 might has potential clinical value in the diagnosis and following - up of myocarditis.

关 键 词：心肌炎 半乳糖凝集素-9(galectin-9) γ干扰素(IFN-γ) 白细胞介 素-4(IL-4) 

分 类 号：R562.25[医药卫生—呼吸系统]