摘要
目的观察外周血单核细胞血红蛋白清道夫受体CD163在不同病因慢性心力衰竭(chronic heart failure,CHF)患者中的表达水平,探讨其在CHF发病中的意义。方法选择2015年2月至2016年4月在上海市浦东医院心血管内科住院的124例纽约心脏学会(New York Heart Association,NYHA)心功能分级Ⅱ~Ⅳ级的CHF患者作为CHF组和63例无基础心脏疾病的受试者作为对照组,CHF组包括冠状动脉粥样硬化性心脏病(冠心病)、高血压性心脏病和心肌病3个亚组。所有研究对象均采用流式细胞术测定外周血CD163表达水平,检测外周血白细胞计数、中性粒细胞计数、单核细胞计数、血清丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)、肌酐(Cr)、空腹血糖(FPG)、三酰甘油(triacylglycerol,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein-cholesterol,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、C-反应蛋白(C-reactive protein,CRP)、白细胞介素-1β(interlekin-1β,IL-1β)、白细胞介素-6(interlekin-6,IL-6)、血红素氧合酶-1(hemeoxygenese-1,HO-1)、丙二醛(malonaldehyde,MDA)、脑钠肽以及左心室射血分数、收缩压、舒张压、体质量指数等相关指标,评估NYHA心功能分级,同时询问吸烟、高血压、糖尿病及脑卒中史。结果 (1)CHF组外周血单核细胞CD163、炎症细胞因子CRP、IL-1β、IL-6和氧化应激指标HO-1、MDA浓度显著高于对照组,差异有统计学意义(P<0.01)。(2)CHF组NYHAⅡ级、Ⅲ级、Ⅳ级患者CD163、CRP、IL-1β、IL-6、HO-1和MDA浓度比较,差异有统计学意义(P<0.01);NYHAⅣ级患者CD163、CRP、IL-1β、IL-6、HO-1、MDA浓度显著高于NYHAⅢ级和Ⅱ级患者,差异有统计学意义(P<0.01);NYHAⅢ级患者CD163、CRP、IL-1β、IL-6、HO-1、MDA浓度显著高于Ⅱ级患者,差异有统计学意义(P<0.01)。(3)性别、吸烟、高血压、糖尿病和脑卒中史不影响CD163表达水平(P>0.05)。(4)Logistic多元逐步回归分析显示,调整年龄、高血压、糖尿病、脑卒中史、收缩压、舒张压、血红蛋白、肌酐等危险因素后,CD163仍与CHF显著相关(P<0.05)。结论 CHF组外周血单核细胞CD163及炎症细胞因子CRP、IL-1β、IL-6和氧化应激指标HO-1、MDA浓度显著升高,并且与心功能状况相关。CD163可能与CHF的发生机制有关。
Objectives To observe the expression of hemoglobin scavenger receptor CD163in peripheral blood monocytes(MON)in different cause of chronic heart failure(CHF)patients and investigate its significance in the pathogenesis of CHF.Methods From February2015to April2016,we recruited124CHF patients hospitalized in Cardiology of Shanghai Pudong Hospital whose cardiac function status were gradeⅡto gradeⅣaccording to cardiac function stardand of New York Heart Association(NYHA)as CHF group,and63subjects without underlying heart disease as control group.CHF group included three subgroups:coronary heart disease(CHD)subgroup,hypertensive heart disease(HHD)subgroup and cardiomyopathy(CM)subgroup.CD163was 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 blood glucose(FPG),lipids[triacylglycerol(TG),total cholesterol(TC),low-density lipoprotein-cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)],inflammatory factor[C-reaction protein(CRP),interleukin-1β(IL-1β),interleukin-6(IL-6)],oxidative stress marker[heme oxygenase-1(HO-1),malondialdehyde(MDA)],brain natriuretic peptide(BNP)and left ventricular ejection fraction(LVEF),systolic blood pressure(SBP),diastolic blood pressure(DBP),body mass index(BMI)were measured.Age,sex,NYHA cardiac function status and past history including smoking status,hypertension,diabetes mellitus,and stroke were obtained from all participants.Results(1)MON CD163,inflammatory factor CRP,IL-1β,IL-6and oxidative stress marker HO-1,MDA concentrations in peripheral blood of CHF patients were significantly higher than those in controls(P<0.01).(2)CD163,CRP,IL-1β,IL-6,HO-1and MDA concentrations among NYHAⅡgroup,NYHAⅢgroup and NYHAⅣgroup CHF patients were significantly different(P<0.01),they in NYHAⅣgroup were significantly higher than those in NYHAⅢgroup and NYHAⅡgroup(P<0.01),in NYHAⅢgroup were significantly higher than those in NYHAⅡgroup(P<0.01).(3)Gender,smoking status and hypertension,diabetes mellitus,stroke history didn′t affected CD163expression level(P>0.05).(4)Based on Logistic multiple regression analysis,after adjusting age,hypertension,diabetes mellitus,stroke history and SBP,DBP,hemoglobin,Cr,the association of CD163with CHF was significant(P<0.05).Conclusions MON CD163,inflammatory factor CRP,IL-1β,IL-6and oxidative stress marker HO-1,MDA concentrations elevate significantly in peripheral blood of CHF patients,and correlate with cardiac function status.CD163may be involved in the pathogenesis of CHF.
作者
李志强
王春燕
石毅
梁永俊
胡春燕
LI Zhi-qiang;WANG Chun-yan;SHI Yi;LIANG Yong-jun;HU Chun-yan(Department of Cardiology,Shanghai Pudong Hospital,Fudan University Pudong Medical Center,Shanghai 201399,China;Department of Clinical Laboratory,Shanghai Pudong Hospital,Fudan University Pudong Medical Center,Shanghai 201399,China;Department of Innovation Center,Shanghai Pudong Hospital,Fudan University Pudong Medical Center,Shanghai 201399,China)
出处
《岭南心血管病杂志》
2018年第1期60-65,共6页
South China Journal of Cardiovascular Diseases
基金
上海市卫生和计划生育委员会基金资助(项目编号:20134154)
上海市浦东新区卫生系统领先人才培养计划资助(项目编号:PWRI2014-03)
