肺炎支原体感染对慢性心力衰竭TLR4/NF-κB信号通路表达的影响  

Effects of Mycoplasma pneumoniae infection on the expression of TLR4/NF-κB signal pathway in patients with chronic heart failure

作　　者：张琮[1] 赵佩 张占海[2] 张清会[2] 黄柳 ZHANG Cong;ZHAO Pei;ZHANG Zhan-hai;ZHANG Qing-hui;HUANG Liu(The First Affiliated Hospital of Nanyang Medical College,Nanyang f Henan 473000,China;不详)

机构地区：[1]南阳医学高等专科学校第一附属医院特需病房,河南南阳473000 [2]南阳医学高等专科学校第一附属医院心血管内科,河南南阳473000

出　　处：《中华医院感染学杂志》2021年第15期2267-2271,共5页Chinese Journal of Nosocomiology

基　　金：河南省医学科技攻关计划基金资助项目(201702201)。

摘　　要：目的探讨肺炎支原体(MP)感染对慢性心力衰竭(CHF)患者Toll-样受体4/核因子κB(TLR4/NF-κB)信号通路表达的影响。方法选择2015年9月-2020年9月在南阳医学高等专科学校第一附属医院确诊的41例CHF合并MP感染患者为CHF合并MP组,以同期医院收治的41例单纯CHF患者为CHF组。入组第2天,采用彩色多普勒超声仪检测所有患者的心功能;检测血白细胞(WBC)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、心肌肌钙蛋白I(cTnI)、氨基N末端B型利钠肽前体(NT-proBNP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)和降钙素原(PCT)水平;荧光定量聚合酶链反应(PCR)和蛋白质印迹(western blot)检测TLR4/NF-κB信号通路表达。结果CHF合并MP组患者的左心室射血分数(LVEF)低于CHF组(P<0.05),血清心功能相关指标CK-MB、LDH、cTnI和NT-proBNP水平高于CHF组(P<0.05),免疫炎症相关指标WBC、IL-6、TNF-α、CRP和PCT水平高于CHF组(P<0.05);TLR4、NF-κB和TNF-αmRNA高于CHF组(P<0.05),TLR4、NF-κB和p-IκB蛋白水平高于CHF组(P<0.05)。结论MP感染可以激活TLR4/NF-кB信号通路表达,促进炎症因子释放,加重CHF患者的心脏结构和功能损伤。OBJECTIVE To explore the effects of Mycoplasma pneumoniae(MP)infection on the expression of molecules in Toll-like receptor 4/nuclear factorκB(TLR4/NF-κB)signaling pathway in patients with chronic heart failure(CHF).METHODS A total of 41 patients confirmed with CHF and MP infection in the First Affiliated Hospital of Nanyang Medical College from Sep 2015 to Sep 2020 were enrolled as the CHF-MP group,while 41 CHF patients during the same period were enrolled as the CHF group.On the second day of enrollment,cardiac function in all patients was detected by color Doppler ultrasound.The levels of serum white blood cell(WBC),creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH),cardiac troponin I(cTnI),N-terminal B-type precursor of n-amino natriuretic peptide(NT-proBNP),interleukin 6(IL-6),tumor necrosis factorα(TNF-α),C reactive protein(CRP)and procalcitonin(PCT)were detected.The expression of molecules in TLR4/NF-κB signaling pathway was detected by fluorescent quantitative polymerase chain reaction(FQ-PCR)and Western blot.RESULTS The left ventricular ejection fraction(LVEF)in the CHF-MP group was significantly lower than that in the CHF group(P<0.05),levels of serum cardiac function-related indexes such as CK-MB,LDH,cTnI and NT-proBNP were significantly higher than those in the CHF group(P<0.05),and levels of immune inflammation-related indexes including WBC,IL-6,TNF-α,CRP and PCT were significantly higher than those in the CHF group(P<0.05).The mRNA levels of TLR4,NF-κB and TNF-αin the CHF-MP group were significantly higher than those in the CHF group(P<0.05),and protein levels of the indexes were also significantly higher than those in the CHF group(P<0.05).CONCLUSION MP infection can activate the expression of TLR4/NF-кB signaling pathway,promote the release of inflammatory factors and aggravate the damage of cardiac structure and function in the CHF patients.

关 键 词：慢性心力衰竭 肺炎支原体 心功能 Toll-样受体4/核因子κB信号通路 

分 类 号：R541[医药卫生—心血管疾病]