摘要
目的探讨Toll样受体4(TLR-4)信号通路分子变化与慢性心力衰竭(CHF)严重程度和预后的关系。方法选择本院收治的117例CHF患者(病例组)和同期109例健康对照者(对照组),采用流式细胞仪检测其外周血单核细胞中TLR-4、核转录因子kappa B(NF-κB)和髓样分化因子(My D88)的表达情况,分析它们与CHF的心功能分级、浆膜腔积液、再次入院和全因死亡的关系。结果病例组的外周血单核细胞的TLR-4、NF-κB和My D88水平均显著高于对照组(均P<0.05);不同NYHA分级CHF患者的TLR-4(F=4.026,P=0.032)、NF-κB(F=5.152,P=0.025)和My D88(F=7.323,P=0.019)水平具有显著差异;随访期间发生全因死亡患者的TLR-4(t=-2.149,P=0.033)和My D88(t=-2.506,P=0.014)水平显著高于未死亡者;TLR-4作为预测发生全因死亡的灵敏度和特异度分别为83%和77%,而My D88分别为77%和71%。结论 TLR-4信号通路分子与CHF的心功能密切相关,TLR-4和My D88是潜在的全因死亡预测分子。
Objective To explore the relationship between the Toll-like receptor 4 （TLR-4） signaling pathways and the severity and prognosis of patients with chronie heart failure （CHF）. Method Total 117 patients with CHF treated during June 2014 to May 2015 and 109 healthy eontrols were recruited;TLR-4,nuclear factor kappa B （NF-κB） and myeloid differentiation factor （MyD88） expression in peripheral blood mononuclear cells were examined by flow cytometry;the associations of these factors with CHF of NYHA, effusion, readmission, and all-cause mortality were analyzed. Results TLR-4, NF-κB and MyD88 in patients group were higher than control group （P〈0.05） ;patients with different NYHA have signifieantly different TLR-4 （ F = 4.026, P = 0.032）, NF-κB （ F = 5.152, P = 0.025 ） and MyD88 （ F = 7.323, P = 0.019 ） levels;TLR-4 （t=-2.149,P=0.033） and MyD88 （t=-2.506,P=0.014） in patients who died due to the disease during follow-up were significantly higher than those who had not died;TLR-4 as a predictor of all-cause mortality had sensitivity and specificity of 83% and 77%, while MyD88 had 77% and 71%. Conclusion TLR4 signaling pathway moleeules closely related to cardiac function of patients with CHF,TLR-4 and MyD88 may be potential all-cause mortality predictions in that disease.
出处
《中南医学科学杂志》
CAS
2016年第6期653-656,714,共5页
Medical Science Journal of Central South China
关键词
TOLL样受体4
慢性心力衰竭
心功能
预后
Toll-like receptor 4
chronic heart failure
cardiac function
prognosis
