不同程度CHF患者血清炎症因子的变化及发病机制研究  

Study on the Changes of Serum Inflammatory Factors and Pathogenesis in Patients with CHF of Different Degrees

作　　者：谢启海 李宏松[1] 王立芳 陈霞[1] 许向东[1] XIE Qi-hai;LI Hong-song;WANG Li-fang(Department of Cardiovascular Medicine,Jiading District Central Hospital Affiliated to Shanghai Health Medical College,Shanghai 201800)

机构地区：[1]上海健康医学院附属嘉定区中心医院心血管内科,上海201800

出　　处：《医学临床研究》2019年第11期2084-2087,共4页Journal of Clinical Research

基　　金：上海市卫生和计划生育委员会科研课题计划(课题编号20164Y0049)。

摘　　要：【目的】探讨NOD-like-Receptor protein 3(NLRP3)炎症小体活化对慢性心力衰竭(CHF)患者心功能分级的相关性。【方法】选择本院于2017年6月至2018年6月期间收治的CHF患者50例,NYHA心功能分级:Ⅱ级13例,Ⅲ级23例,Ⅳ级14例;另选择本院同期健康体检者50例作为对照组。采用免疫蛋白印迹分析测定两组受试者NLRP3、白介素-1β(IL-1β)和白介素-18(IL-18)蛋白表达灰度值(OD);采用酶联免疫吸附法测定IL-1β和IL-18水平(pg/mL);采用超声心动图评估患者左室射血分数(LVEF)和左室舒张末内径(LVEDd)。【结果】CHF组患者NLRP3、IL-1β和IL-18蛋白表达OD值高于对照组,差异具有统计学意义(P<0.05)。随着患者心功能损害加重(Ⅱ~Ⅳ),NLRP3、IL-1β和IL-18蛋白表达OD值逐渐升高,且各级心功能组血清IL-1β和IL-18水平亦逐渐升高,而LVEF逐渐降低,LVEDd逐渐升高,其差异均具有统计学意义(P<0.05)。NLRP3、IL-1β和IL-18表达与心功能分级Ⅳ级呈线性正相关。【结论】NLRP3炎症小体活化可能参与CHF发病过程,且与心功能分级密切相关。【Objective】To explore the correlation between the activation of NOD-like-Receptor protein 3(NLRP3)inflammatory corpuscles and the classification of heart function in patients with chronic heart failure(CHF).【Methods】From June 2017 to June 2018,50 patients with CHF were enrolled in our hospital.NYHA heart function grading:13 patients of gradeⅡ,23 patients of gradeⅢ,14 patients of gradeⅣ;another 50 healthy people of our hospital at the same period were selected as the control group.The expression of NLRP3,IL-1β(IL-1β)and IL-18(OD)in the two groups were measured by Western blot analysis,the levels of IL-1βand IL-18(PG/mL)were measured by enzyme-linked immunosorbent assay,and the left ventricular ejection fraction(LVEF)and left ventricular end diastolic diameter(LVEDd)were evaluated by echocardiography.【Results】The OD value of NLRP3,IL-1βand IL-18 protein expression in CHF group was higher than that in the control group(P<0.05).With the aggravation of heart function damage(Ⅱ~Ⅳ),the OD value of NLRP3,IL-1βand IL-18 protein expression gradually increased,and the serum IL-1βand IL-18 levels also gradually increased in all levels of the heart function groups,while the LVEF gradually decreased,and the LVEDd gradually increased,the difference was statistically significant(P<0.05).The expression of NLRP3,IL-1βand IL-18 was positively correlated with cardiac function gradeⅣ.【Conclusion】The activation of NLRP3 inflammatory corpuscles may be involved in the pathogenesis of CHF and is closely related to the classification of cardiac function.

关 键 词：心力衰竭/病理生理学 细胞因子类 

分 类 号：R541.6[医药卫生—心血管疾病]