柯萨奇B族病毒感染性心肌炎外周血TLR3、IFN-β及PAR-1表达及临床意义  

Expressions of TLR3,IFN-βand PAR-1 in peripheral blood of patients with Coxsackie B virus infectious myocarditis and clinical significance

作　　者：华朋铎[1] 石全宝[1] 杨楠[1] 井河江 孟红社 白雪蕾 HUA Peng-duo;SHI Quan-bao;YANG Nan;JING He-jiang;MENG Hong-she;BAI Xue-lei(Nanyang Second People’s Hospital,Nanyang,Henan 473000,China)

机构地区：[1]南阳市第二人民医院心血管内科,河南南阳473000

出　　处：《中华医院感染学杂志》2022年第21期3263-3267,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(LHGJ20191464)。

摘　　要：目的探讨柯萨奇B族病毒(CBV)感染性心肌炎患者外周血Toll样受体3(TLR3)、干扰素-β(IFN-β)及蛋白酶激活受体-1(PAR-1)表达及临床意义。方法选取2016年3月-2020年5月南阳市第二人民医院收治的84例CBV感染性心肌炎患者为研究对象,统计患者随访1年后预后情况,比较不同预后患者外周血TLR3、IFN-β及PAR-1表达水平,采用多因素Logistic回归分析、相关性分析和受试者工作特征(ROC)曲线分析TLR3、IFN-β及PAR-1与CBV感染性心肌炎患者预后之间的关系。结果经随访1年,84例患者中有64例预后良好(76.19%),20例预后不良(23.81%)。预后不良组TLR3、IFN-βmRNA相对表达量低于预后良好组(P<0.05),PAR-1 mRNA相对表达量高于预后良好组(P<0.05);ROC分析结果显示,外周血TLR3、IFN-β及PAR-1 mRNA相对表达量联合预测CBV感染性心肌炎患者不良预后的曲线下面积(AUC)均高于三项指标单独预测的AUC值(P<0.05);相关性分析结果显示,外周血TLR3、IFN-β表达分别与临床痊愈、恢复迁延呈正相关性(P<0.05),与心律失常、扩张型心肌病呈负相关性(P<0.05),PAR-1则相反。多因素分析结果显示,TLR3 mRNA<1.34、IFN-βmRNA<1.48是CBV感染性心肌炎患者预后不良的重要影响因素(P<0.05)。结论TLR3、IFN-β在CBV感染性心肌炎预后不良患者外周血呈较低表达,PAR-1则呈较高表达,上述指标联合检测对患者预后有较高预测价值。OBJECTIVE To explore the expressions of Toll-like receptor 3(TLR3),interferon-β(IFN-β)and protease activated receptor-1(PAR-1)in peripheral blood of patients with Coxsackie B virus(CBV)infectious myocarditis and analyze the clinical significance.METHODS A total of 84 patients with CBV infectious myocarditis who were treated in Nanyang Second People’s Hospital from Mar 2016 to May 2020 were recruited as the study subjects,the prognosis of the patients was statistically analyzed after 1-year follow-up.The expression levels of peripheral blood TLR3,IFN-βand PAR-1 were compared among the patients with different prognosis,and the relationship between the TLR3,IFN-β,PAR-1 and the prognosis of the patients with CBV infectious myocarditis was observed by means of multivariate logistic regression analysis,correlation analysis and receiver operating characteristic(ROC)curve analysis.RESULTS After 1-year follow-up for 84 patients,64(76.19%)had favorable prognosis,and 20(23.81%)had poor prognosis.The relative expression levels of TLR3 and IFN-βmRNA of the poor prognosis group were lower than those of the favorable prognosis group(P<0.05),while the relative expression level of PAR-1 mRNA of the poor prognosis group was higher than that of the favorable prognosis group(P<0.05).The result of ROC analysis showed that the area under curve(AUC)of the joint detection of peripheral blood TLR3,IFN-βand PAR-1 mRNA was greater than that of the single index(P<0.05);the result of correlation analysis indicated that the expressions of peripheral blood TLR3 and IFN-βwere respectively and positively correlated with clinical recovery and recovery delay(P<0.05)and were negatively correlated with arrhythmia and dilated cardiomyopathy(P<0.05),PAR-1 was opposite.The result of multivariate analysis showed that TLR3 mRNA less than 1.34 and IFN-βmRNA less than 1.48 were major influencing factors for the poor prognosis of the patients with CBV infectious myocarditis(P<0.05).CONCLUSION The CBV infectious myocarditis patients with poor progn

关 键 词：柯萨奇B族病毒 感染性心肌炎 外周血Toll样受体3 干扰素-Β 蛋白酶激活受体-1 表达水平 预后 

分 类 号：R542.21[医药卫生—心血管疾病]