心力衰竭患者血浆sIGF-1、sTRAIL、sDR5水平的变化及其相关性

Changes in plasma levels of soluble IGF-1,TRAIL,and DR5 and their correlations in patients with congestive heart failure

目的探讨充血性心力衰竭患者血浆可溶性胰岛素生长因子-1（sIGF-1）、肿瘤坏死因子相关的凋亡诱导配体（sTRAIL）、死亡受体（sDR5）水平及其相关性。方法分别用放射免疫法、酶联免疫吸附法（ELISA）检测80例CHF患者和30例健康人（对照组）血浆sIGF—I、sTRAIL、sDR5水平，用多普勒超声心动图测定CHF患者左室射血分数（LVEF）。结果（1）CHF患者与对照组比较，血浆sIGF-1水平明显降低（P〈0．01）；sDR5水平明显升高（P〈0．01），且随心功能损害程度的加重而发生变化；sTRAIL水平升高（P〉0．05）；（2）LVEF与sIGF-1水平呈显著的正相关（r=0．431，P〈0．01），与sDR5水平呈显著的负相关（r=-0．524，P〈0．01）；（3）sIGF-1、sDR5间呈显著的负相关（r=-0．293，P〈0．01）。结论血浆slGF-1、sDR5水平可能是评价CHF患者心功能和心肌细胞凋亡状态有价值的指标之一。

Objective To investigate the Correlation and the plasma levels of soluble IGF- 1, sTRAIL, and sDR5 and their correlations in patients with congestive heart failure （CHF）. Methods The plasma levels of sIGF - 1, sTRAIL, and sDR5 were determined by radioimmunoassay and ELISA in 80 CHF patients and in 30 healthy subjects as controls.Left ventricular ejection fraction （LVEF） in patients with CHF was measured by colour Dopper echecardingraphy. Results （1） The levels of slGF- 1 in the patients with CHF were lower than those in control group, with a significant difference（ P 〈 0.01） while the levels of sDR5 were significantly higher than those in control group（ P 〈 0.01） .The level of sTRAIL in the patients with CHF were higher than those in control group, but there was no significant difference（ P 〉 0.05）.The levels of sTRAIL had no significant correlation with cardiac function. （2） LVEF was positively correlated to the plasma level of sIGF- 1（ r =0.431, P 〈 0.01）and negatively correlated with sDRS（ r = -0.524, P 〈 0.01）. （3）The plasma level of sIGF- 1 negatively correlated with the plasma level of sDRS（ r = -0.293, P 〈0.01）. Conclusions The plasma levels of sIGF- 1 and sDR5 may be important parameters for determination of cardiac function degree and evalufion of the level of myocardial cell apoptosis.