缺血性心肌病及扩张型心肌病患者血清炎症因子的表达及临床意义探讨  

Expression of serum inflammatory factors and its clinical significance in patients with ischemic cardiomyopathy or dilated cardiomyopathy

作　　者：张梦雨 王田 孟凡静 尉希清[2] 杨俊华[1] Zhang Mengyu;Wang Tian;Meng Fanjing;Wei Xiqing;Yang Junhua(Department of Cardiology,the First Affiliated Hospital of Soochow University,Suzhou 215006,China;Department of Cardiology,the Affiliated Hospital of Jining Medical University,Jining 272129,China)

机构地区：[1]苏州大学附属第一医院心内科,215006 [2]济宁医学院附属医院心内科,272129

出　　处：《中华老年医学杂志》2018年第11期1185-1189,共5页Chinese Journal of Geriatrics

基　　金：国家科技部科技支撑计划（2015BAI12B02）

摘　　要：目的观察扩张型心肌病（DCM）和缺血性心肌病（ICM）患者血清中炎症因子半乳糖凝集素-3（Gal-3）、分形趋化因子（FKN）、白细胞介素-6（IL-6）的不同变化，探讨其临床意义。方法选择2016年10月至2017年12月在心内科住院的DCM患者76例为DCM组，另选取ICM患者78例患者ICM组，并分别进行心功能分级，同时选取同一医院同期健康体检者82例为正常对照组，空腹抽取静脉血，检测和比较三组患者血清中Gal-3、FKN、IL-6因子水平及BNP水平，并研究Gal-3、FKN及IL-6与DCM和ICM的关系。结果DCM和ICM两组患者的血浆BNP及血清Gal-3、FKN、IL-6水平均高于正常对照组，且DCM患者组高于ICM患者；DCM和ICM患者两组随美国纽约心脏病学会（NYHA）心功能分级升高，BNP、Gal-3、FKN、IL-6水平呈增高趋势，但在相同心功能分级，DCM患者组血清Gal-3、FKN、IL-6水平明显高于ICM组（P〈0.05），两组患者血浆BNP水平无显著性差异（P〉0.05）。Spearman相关分析显示，DCM和ICM两组患者的BNP（r＝0.30，0.19）、Gal-3（r＝0.24，0.19）、FKN（r＝0.63，0.51）及IL-6（r＝0.28，0.15）水平均与NYHA分级呈正相关（P〈0.05），且DCM组相关性更强。结论DCM与ICM患者存在明显的血浆BNP、Gal-3、FKN及IL-6高表达，且与心功能损害严重程度密切相关，监测血浆BNP及血清炎症因子Gal-3、FKN、IL-6的变化对DCM及ICM鉴别诊断、病情判断及治疗决策有重要的临床指导意义。ObjectiveTo analyze changes in serum levels of inflammatory factors, galectin-3（Gal-3）, fractalkine（FKN）and interleukin-6（IL-6）, in patients with dilated cardiomyopathy（DCM）or ischemic cardiomyopathy（ICM）, and to explore their clinical significance.MethodsSeventy-six hospitalized patients with DCM were selected to serve as a DCM group, and 78 patients with ischemic cardiomyopathy were selected into an ICM group from October 2016 to December 2017 at the Department of Cardiology, and patients in the two groups received cardiac function classification.Meanwhile, 82 healthy people were included as a control group.Fasting venous blood was collected, and serum levels of Gal-3, FKN, IL-6, and BNP were measured.The correlations of Gal-3, FKN, and IL-6 with DCM or ICM were analyzed.ResultsLevels of plasma BNP and serum Gal-3, FKN, and IL-6 in the DCM and ICM groups were higher than those in the control group, and their levels in the DCM group were significantly higher than in the ICM group.Levels of plasma BNP and serum Gal-3, FKN, and IL-6 increased as their New York Heart Association（NYHA）classification went higher in both the DCM and ICM groups.For patients classified at the same level, serum levels of Gal-3, FKN, and IL-6 of the DCM group were significantly higher than those of the ICM group（P〈0.05）. BNP levels showed no difference between the two groups（P〉0.05）. Spearman correlation analysis indicated positive correlations of NYHA classification with levels of BNP（r=0.30, 0.19）, Gal-3（r=0.24, 0.19）, FKN（r=0.63, 0.51）, and IL-6（r=0.28, 0.15）in both the DCM and ICM groups（P〈0.05）, and the correlation was stronger in the DCM group.ConclusionsIncreased expression of plasma BNP, Gal-3, FKN, and IL-6 in patients with DCM and ICM are closely related to the severity of cardiac function impairment.Monitoring changes in levels of plasma BNP and serum inflammatory factors Gal-3, FKN and IL-6 provides important clues for the differential diagnosis between DCM and ICM, the

关 键 词：炎症 心肌病 扩张型 心肌病 缺血性 

分 类 号：R542.2[医药卫生—心血管疾病]