扩张型心肌病患者血清sFas、sFasL及sIL-2R水平临床意义的探讨

Clinical significance of serum levels of soluble Fas、soluble Fas ligand and soluble Ⅱ-2 receptor in patients with dilated cardiomyopathy

目的探讨血清sFas、sFasL和sIL-2R水平与扩张型心肌病(DCM)之间的关系。方法应用酶联免疫吸附双抗体夹心(ELISA)方法,测定30例DCM患者(DCM组)和22例对照组患者的血清可溶性Fas(sFas)、可溶性Fas配体(sFasL)和可溶性白细胞介素2受体(sIL-2R)水平。结果血清sFas和血清sIL-2R平均水平,DCM组[(1718.50±119.57)ng/L、(855.00±78.03)ng/L]明显高于对照组[(1259.74±143.22)ng/L、(632.64±94.82)ng/L],有显著性差异。在DCM组中,血清sFas和血清sIL-2R平均水平随其心功能分级(NYHA分级I～IV)升高而增高。DCM组sFasL平均水平[(165.31±138.99)ng/L]与对照组[(169.85±149.63)ng/L]比较无显著性差异。DCM组血清sFas水平与sIL-2R水平存在显著正相关。结论DCM患者血清sFas、sIL-2R水平明显升高,提示其与DCM有关。血清sFas可能通过维持自身免疫炎性反应促进心肌细胞凋亡而导致DCM的发生发展。

Objective To evaluate the relationship between serum levels of soluble Fas.soluble Fas ligand and solub IL-2 receptor, and dilated cardiomyopathy （DCM）. Methods By specific enzyme-linked immunosorbent assay （ELISA）tests, soluble Fas .soluble Fas ligand and soluble IL-2 receptor were measured in the sera of 30 patients with DCM （DCM group）,and 22 controls （Control group）. Results Mean levels of soluble Fas and soluble IL-2 receptor were significantly higher in patients with DCM than those in controls（P〈0.01）. Compared with Control group, the mean level of soluble FasL was lower in DCM group, but the difference was not significant. Mean levels of soluble Fas and soluble IL-2 receptor were elevated parallel with the grades of heart function （NYHA Grade Ⅰ-Ⅳ）. Moreover, soluble Fas and soluble IL-2 receptor were positively correlated in patients with DCM（r=0.441, P〈0.05）. Conclusions Our study demonstrates that levels of soluble Fas and soluble IL-2 receptor in patients with DCM are elevated, which suggests that they may relate to DCM. Serum soluble Fas may facilitate pathogenesis of DCM by perpetuating autoimmune-inflammatory reactions and cardiomyocyte apoptosis.