心肌炎中血脂代谢紊乱及机制  

Lipid metabolism disorder in rat experimental autoimmune myocarditis and myocarditis patients and its possible mechanism

作　　者：常贺 宋颖[2,3] 王跃[2,3] 吴阳 刘春晓 戚智 CHANG He;SONG Ying;WANG Yue;WU Yang;LIU Chun-xiao;QI Zhi(Dept of Geriatrics,Xiang’an Hospital of Xiamen University,Xiamen 361100,China;Dept of Basic Medical Sciences,School of Medicine,Xiamen University,Xiamen 361102,China;Xiamen Cardiovascular Hospital,Xiamen University,Xiamen 361014,China)

机构地区：[1]厦门大学附属翔安医院老年病科,福建厦门361100 [2]厦门大学医学院基础医学部,福建厦门361102 [3]厦门大学附属心血管病医院,福建厦门361014

出　　处：《中国药理学通报》2020年第7期919-926,共8页Chinese Pharmacological Bulletin

基　　金：国家自然科学基金项目(No.81270294);厦门大学附属翔安医院引进高层次人才科研启动基金(No.PM201809170018)。

摘　　要：目的观察大鼠实验性自身免疫性心肌炎(EAM)和心肌炎患者中血脂代谢情况并初步探讨其机制。方法制备大鼠EAM模型,检测EAM不同时程的血脂水平,荧光定量PCR法检测载脂蛋白AopA 1在EAM各组织中的mRNA相对表达量。收集心肌炎患者血浆,检测临床各指标及血脂水平,并进行相关性分析,进一步应用Bio-Plex蛋白悬液芯片系统检测心肌炎患者血清中15种炎性因子的表达。结果大鼠EAM病程中血浆HDL的水平从d 4即开始明显下降,之后持续处于低水平状态,在d 21下降至最低点,持续至d 84仍处于较低水平;ApoA 1在EAM心肌中d 14和d 21的表达水平明显降低。与对照组比较,心肌炎患者血浆中HDL和ApoA 1的水平均明显降低,直线相关分析显示HDL的水平与肌钙蛋白cT NT呈负相关。心肌炎患者血清中IL-1β、IL-6、IL-17A、IL-31、sC D40L、TNF-α的表达水平明显升高,尤其是随着HDL的降低,IL-6、TNF-α的水平升高更明显。结论大鼠EAM和心肌炎患者中存在以HDL降低为主的血脂代谢紊乱,并且HDL的水平与心肌坏死程度及炎症因子的分泌具有相关性。Aim To investigate lipid metabolism disorder in rat experimental autoimmune myocarditis(EAM)and myocarditis patients and the possible mechanism.Methods Rat EAM model was induced,and serum lipid levels during EAM time course were determined.The expression of ApoA1 in different tissues of EAM time course was determined by Quantitative real-time RT-PCR.Plasma of myocarditis patients was collected,and blood routine examination and lipid levels were examined.The clinical data were analyzed using linear correlation analysis.Serum inflammatory genes levels in the myocarditis patients were examined by Bio-Plex protein suspension chip system.Results Serum HDL level significantly decreased from EAM d 4 to d 84,and peak decrease happened on d 21.ApoA1 expression in the heart of EAM rats significantly decreased from d 14 to d 21.Compared with healthy control group,plasma HDL and ApoA1 levels decreased significantly in myocarditis patients.Linear correlation analysis showed that the levels of HDL and cTNT had a negative correlation.The serum inflammatory genes levels IL-1β,IL-6,IL-17A,IL-31,sCD40L and TNF-αincreased significantly in myocarditis patients.With the decrease of HDL,the level of IL-6 and TNF-αincreased more markedly.Conclusions Lipid metabolism disorder and plasma HDL levels decrease in rat EAM and myocarditis patients,and HDL levels are correlated with myocardial necrosis and secretion of inflammatory genes.

关 键 词：自身免疫性心肌炎 心肌坏死 血脂紊乱 高密度脂蛋白 载脂蛋白A1 炎症因子 

分 类 号：R-332[医药卫生] R344