慢性心衰病人血红蛋白清道夫受体CD163表达及其与心功能的关系  

Relationship between Hemoglobin Scavenger Receptor CD163 Concentration and Cardiac Function in Patients with Chronic Heart Failure

作　　者：王春燕[1] 李锦玉[1] 李志强[1] 马晶[1] 蒋庆渊[1] 石毅[1] 胡春燕[1] Wang Chunyan;Li Jinyu;Li Zhiqiang;Ma jing;Jiang Qingyuan;Shi Yi;Hu Chunyan(Shanghai Pudong Hospital,Fudan University Pudong Medical Center,Shanghai 201399,China)

机构地区：[1]上海市浦东医院/复旦大学附属浦东医院,上海201399

出　　处：《中西医结合心脑血管病杂志》2017年第3期327-331,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：上海市卫生和计划生育委员会科研项目(No.20134154);浦东新区卫生和计划生育委员会领先人才培养科研项目(No.PWRl 2014-03)

摘　　要：目的观察不同病因慢性心力衰竭(CHF)病人外周血单核细胞(MON)血红蛋白清道夫受体CD163的CHF病人表达水平,探讨CD163与其他炎症因子和心功能的关系。方法选择2015年2月—2016年4月在上海市浦东医院心血管内科住院的124例CHF病人,并纽约心脏病学会(NYHA)心功能分级Ⅱ级~Ⅳ级作为CHF组,63例无基础心脏疾病的受试者作为对照组。CHF组包括冠心病(CHD)、高血压性心脏病(HHD)和心肌病(CM)3个亚组。所有研究对象均采用流式细胞术测定外周血MON CD163表达水平,检测外周血白细胞(WBC)计数、中性粒细胞(NEU)计数、MON计数、血清谷丙转氨酶(ALT)、总胆红素(TBIL)、肌酐(Cr)、空腹血糖(FPG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、C-反应蛋白(CRP)、白介素-1β(IL-1β)、白介素-6(IL-6)、血红素氧合酶-1(HO-1)、丙二醛(MDA)、脑钠肽(BNP)以及左室射血分数(LVEF)、收缩压(SBP)、舒张压(DBP)、体重指数(BMI)等相关指标,评估NYHA心功能分级,同时询问吸烟、高血压病、糖尿病及脑卒中史。结果1CHF组外周血MON CD163、炎症细胞因子CRP、IL-1β、IL-6和氧化应激指标HO-1、MDA水平显著高于对照组(P<0.01)。2CHF组的CHD、HHD、CM 3个亚组间CD163、CRP、IL-1β、IL-6、HO-1和MDA水平无统计学意义(P>0.05)。3 CHF组的CHD、HHD、CM 3个亚组NYHAⅡ级、Ⅲ级、Ⅳ级病人CD163、CRP、IL-1β、IL-6、HO-1和MDA水平存在统计学意义(P<0.01),NYHAⅣ级病人CD163、CRP、IL-1β、IL-6、HO-1、MDA水平显著高于NYHAⅢ级和Ⅱ级病人(P<0.01),NYHAⅢ级病人CD163、CRP、IL-1β、IL-6、HO-1、MDA水平显著高于Ⅱ级病人(P<0.01)。4CD163与MON、CRP、IL-1β、IL-6、HO-1、MDA、BNP、LVEF呈明显正相关(P<0.05或P<0.01),与年龄、BMI、SBP、DBP、WBC、NEU、HB、PLT、FPG、ALT、TBIL、Cr、TC、TG、LDL-C、HDL-C无相关性(P>0.05)。结论CHF组外周血MON CD163、炎症细胞因子CRObjective To observe the expression of hemoglobin scavenger receptor CD163 in peripheral blood monocytes (MON)indifferent cause of chronic heart failure (CHF)patients,and evaluate the relationship between CD163 concentration and cardiac func- tion.Methods From February 2015 to April 2016 in department of cardiology,Shanghai Pudong Hospital,one hundred and twentyfour CHF patients with the cardiac function grade Ⅱ to grade Ⅳ according to the cardiac function stardand of New York Heart Asso- ciation (NYHA)were recruited as CHF group.Sixty three subjects without underlying heart disease were as control group.The CHFgroup included three subgroups:coronary heart disease (CHD)group,hypertensive heart disease (HHD)group and cardiomyopathy(CM)group.CD163 was detected using a flow cytometry protocol.Peripheral blood white blood cell (WBC),neutrophil (NEU),MON, serum alanine transarninase (ALT),total bilirubin (TBIL),creatinine (Cr),fasting plasma glucose (FPG),blood lipids (TC,TG,LDLC,HDL C),inflammatory factor [C reaction protein (CRP),interleukin (IL) 1β,IL 6],oxidative stress marker [heme oxygenase 1(HO 1),malondialdehyde (MDA)],brain natriuretic peptide (BNP)and left ventricular ejection fraction (LVEF),contractive bloodpressure (SBP),diastolic blood pressure (DBP),body mass index (BMI)were measured.Age,sex,the NYHA cardiac function gradeand past history including smoking status,hypertension,diabetes mellitus,and stroke were obtained from all participants.Results TheMON CD163,inflammatory factor CRP,IL 1β,IL 6 and oxidative stress marker HO 1,MDA concentrations in peripheral blood ofCHF patients were significantly higher than those in controls(P <0.01).There was no difference in CD163,CRP,IL 1β,IL 6,HO 1and MDA levels among the CHD,HHD and CM three subgroups in CHF group (P >0.05).There was difference in CD163,CRP,IL1β,IL 6,HO 1 and MDA levels among the NYHA Ⅱ group,NYHA Ⅲ group and NYHA Ⅳ group in the CHD,HHD and CM threeCHF subgroups (P <0.01).The levels of CD163,CRP,IL 1β,IL 6,HO 1 and MDA in NYHA Ⅳ

关 键 词：慢性心力衰竭 血红蛋白清道夫受体 CD163 心功能 血脂 炎症因子 

分 类 号：R541.6[医药卫生—心血管疾病] R256.2[医药卫生—内科学]