中华风湿病学杂志
中華風濕病學雜誌
중화풍습병학잡지
CHINESE JOURNAL OF RHEUMATOLOGY
2011年
10期
660-665
,共6页
红斑狼疮,系统性%白细胞介素17%心肌标志物%孤核受体Υt%心脏损害
紅斑狼瘡,繫統性%白細胞介素17%心肌標誌物%孤覈受體Υt%心髒損害
홍반랑창,계통성%백세포개소17%심기표지물%고핵수체Υt%심장손해
Lupus erythematosus,systemic%Interleukin-17%Cardiac markers%RORγt%Cardiac involvement
目的 探讨辅助性T细胞(Th)17介导的炎症损伤与系统性红斑狼疮(SLE)心脏损害的关系,了解若干常用的心肌标志物作为狼疮心脏受累预测、评价指标的可行性.方法 采用酶联免疫吸附试验( ELISA)法检测47例SLE心脏损害患者、55例SLE无心脏损害患者及38名健康对照血清白细胞介素(IL)-17A水平；应用ADVIA Centaur(R) XP系统与Olympus AU2700全自动生化仪检测心肌标志物水平；应用实时荧光定量聚合酶链反应(real-time qPCR)方法相对定量13例SLE心脏损害患者、14例SLE无心脏损害患者及13名健康对照外周血单个核细胞(PBMCs)中孤核受体(ROR)Υt基因表达水平.计量资料的比较采用Kruskal-Wallis检验、Mann-Whitney U检验或独立样本F检验,相关性分析采用直线回归或Spearman相关分析.结果 ①SLE心脏损害组血清IL-17A水平较SLE无心脏损害组及健康对照组均显著升高[27.98(8.44～138.81),11.12(3.64～22.30),5.77(2.22～9.60) pg/ml;P均＜0.05].②SLE心脏损害组脑利钠肽水平较SLE无心脏损害组及健康对照组均显著升高[49(13.50～107.50),17(9～26),7.50(4.75～13)pg/ml;P均＜0.01].③SLE心脏损害组年龄、SLE疾病活动度、病程较SLE无心脏损害组均显著升高(P＜0.01或P＜0.05).④SLE心脏损害组RORΥt基因表达水平较SLE无心脏损害组及健康对照组均显著升高[2.2(0.79～2.83),0.72(0.39～1.14),0.19(0.15～0.75);P＜0.05].结论 ①Th17细胞可能参与了SLE心脏损害的发生；②高龄、病程长及疾病活动度高的SLE患者心脏损害发生概率增高；③脑利钠肽有望成为SLE心脏损害的预测、评价指标.
目的 探討輔助性T細胞(Th)17介導的炎癥損傷與繫統性紅斑狼瘡(SLE)心髒損害的關繫,瞭解若榦常用的心肌標誌物作為狼瘡心髒受纍預測、評價指標的可行性.方法 採用酶聯免疫吸附試驗( ELISA)法檢測47例SLE心髒損害患者、55例SLE無心髒損害患者及38名健康對照血清白細胞介素(IL)-17A水平；應用ADVIA Centaur(R) XP繫統與Olympus AU2700全自動生化儀檢測心肌標誌物水平；應用實時熒光定量聚閤酶鏈反應(real-time qPCR)方法相對定量13例SLE心髒損害患者、14例SLE無心髒損害患者及13名健康對照外週血單箇覈細胞(PBMCs)中孤覈受體(ROR)Υt基因錶達水平.計量資料的比較採用Kruskal-Wallis檢驗、Mann-Whitney U檢驗或獨立樣本F檢驗,相關性分析採用直線迴歸或Spearman相關分析.結果 ①SLE心髒損害組血清IL-17A水平較SLE無心髒損害組及健康對照組均顯著升高[27.98(8.44～138.81),11.12(3.64～22.30),5.77(2.22～9.60) pg/ml;P均＜0.05].②SLE心髒損害組腦利鈉肽水平較SLE無心髒損害組及健康對照組均顯著升高[49(13.50～107.50),17(9～26),7.50(4.75～13)pg/ml;P均＜0.01].③SLE心髒損害組年齡、SLE疾病活動度、病程較SLE無心髒損害組均顯著升高(P＜0.01或P＜0.05).④SLE心髒損害組RORΥt基因錶達水平較SLE無心髒損害組及健康對照組均顯著升高[2.2(0.79～2.83),0.72(0.39～1.14),0.19(0.15～0.75);P＜0.05].結論 ①Th17細胞可能參與瞭SLE心髒損害的髮生；②高齡、病程長及疾病活動度高的SLE患者心髒損害髮生概率增高；③腦利鈉肽有望成為SLE心髒損害的預測、評價指標.
목적 탐토보조성T세포(Th)17개도적염증손상여계통성홍반랑창(SLE)심장손해적관계,료해약간상용적심기표지물작위랑창심장수루예측、평개지표적가행성.방법 채용매련면역흡부시험( ELISA)법검측47례SLE심장손해환자、55례SLE무심장손해환자급38명건강대조혈청백세포개소(IL)-17A수평；응용ADVIA Centaur(R) XP계통여Olympus AU2700전자동생화의검측심기표지물수평；응용실시형광정량취합매련반응(real-time qPCR)방법상대정량13례SLE심장손해환자、14례SLE무심장손해환자급13명건강대조외주혈단개핵세포(PBMCs)중고핵수체(ROR)Υt기인표체수평.계량자료적비교채용Kruskal-Wallis검험、Mann-Whitney U검험혹독립양본F검험,상관성분석채용직선회귀혹Spearman상관분석.결과 ①SLE심장손해조혈청IL-17A수평교SLE무심장손해조급건강대조조균현저승고[27.98(8.44～138.81),11.12(3.64～22.30),5.77(2.22～9.60) pg/ml;P균＜0.05].②SLE심장손해조뇌리납태수평교SLE무심장손해조급건강대조조균현저승고[49(13.50～107.50),17(9～26),7.50(4.75～13)pg/ml;P균＜0.01].③SLE심장손해조년령、SLE질병활동도、병정교SLE무심장손해조균현저승고(P＜0.01혹P＜0.05).④SLE심장손해조RORΥt기인표체수평교SLE무심장손해조급건강대조조균현저승고[2.2(0.79～2.83),0.72(0.39～1.14),0.19(0.15～0.75);P＜0.05].결론 ①Th17세포가능삼여료SLE심장손해적발생；②고령、병정장급질병활동도고적SLE환자심장손해발생개솔증고；③뇌리납태유망성위SLE심장손해적예측、평개지표.
Objective To investigate the role of Thl7 cells in the pathogenesis of SLE patients with cardiac involvement,and to understand the value of cardiac markers in SLE patients with cardiac involvement.Methods Serum IL-17A levels were measured by enzyme-linked immunosorbent assay in 47 SLE patients with cardiac involvement (group Ⅰ ),55 SLE patients without cardiac involvement (group Ⅱ ) and 38 healthy controls (group Ⅲ ).The ADVIA Centaur(R)-XP immunoassay analysis system and Olympus AU2700 automatic biochemical system were used to measure cardiac markers.Then real time-quantitative polymerase chain reaction was used to measure RORγt mRNA in 13 SLE patients with cardiac involvement,14 SLE patients without cardiac involvement and 13 healthy controls.Kruskal-Wallis test,Mann-Whitney U test,F test and Spearman correlation were used for statistical analysis.Results ① Serum levels of IL-17A were markedly increased in group Ⅰ than group Ⅱ and Ⅲ [27.98 (8.44-138.81) vs 11.12 (3.64-22.30) vs 5.77 (2.22-9.60) pg/ml,both P＜0.05].② Serum levels of BNP were significantly higher in group Ⅰ than group Ⅱ and Ⅲ [49(13.50-107.50) vs 17(9-26) vs 7.50(4.75-13) pg/ml,both P＜0.01 ].③ Age,course,SLEDAI were significantly higher in group Ⅰ SLE patients than group Ⅱ (P＜0.01 or P＜0.05).④ The level of RORγt mRNA were significantly elevated in group Ⅰ compared to group Ⅱ and Ⅲ [2.2(0.79-2.83) vs 0.72(0.39-1.14) vs 0.19(0.15-0.75),P＜0.05].Conclusion ① Th17 cells may contribute to the inflammation of heart in SLE.② The older age,longer course and higher disease activity of SLE patients are risk factors for cardiac involvement in SLE.③ Serum BNP may be a useful indicator in SLE patients with heart involvement.
