短期抗心力衰竭治疗后心肌MMPs/TIMPs及白介素-15、18表达变化研究

Study of Analysis of Expression Change of MMPs/FIMPs and IL-15、18 of Myocardiac Tissue after Short Term Anti Heart Failure Treatment

目的观察在短期标准化治疗心功能不全的扩张型心肌病和缺血性心肌病患者,使其心功能得以改善后,MMPs/TIMPs系统和白介素家族成员-IL-15、IL-18表达的变化,并探讨其在监测病情变化以及临床疗效方面的价值。方法本研究入选51名受试者,年龄在4282岁之间,其中确诊为扩张型心肌病患者29名,缺血性心肌病患者9名以及13名健康者作为对照组。通过酶联免疫法（ELISA）检测患者在入院接受治疗,心功能不全控制前后血清中MMP-1、MMP-3、MMP-9、TIMP-1、IL-18以及IL-15水平的变化。结果研究发现,心功能不全患者,血MMP-1、MMP-3、IL-18以及IL-15水平较对照组明显降低。但在心功能不全的心肌疾病患者之间,上述检测指标的在血清中的水平与心功能分级无明显相关性。在经过短期治疗,心功能得到明显改善后,发现仅心功能不全患者TIMP-1血清水平显著升高,其余指标无明显变化。结论短期标准化治疗后心功能不全患者血中TIMP-1的表达变化,可能与患者心功能改变密切相关,可作为心功能不全患者短期抗心力衰竭治疗效果的监测指标。

Objective Change of matrix metalloproteinases（MMPS）,tissue inhibitors of metalloproteinase（TIMP-1） and interleukin-18（IL-18） have been reported in heart failure patients secondary to cardiomyopathy（DCM or ICM）.However,the short effect of treatment on the levels MMP-1,MMP-3,MMP-9,TIMP-1,IL-18,and IL-15 in patients with heart failure has not been elucidated.Methods We enrolled 51subjects with heart failure age range between 42-85 years old,29 DCM,9 ICM and 13 healthy subjects as control group;we measured the serum levels of these markers by using enzyme immunoassay（ELISA）.Results The serum level of MMP-1,MMP-3,IL-18,IL-15 in heart failure patients were significant lower compared to that of control group before treatment.And the serum levels of TIMP-1 in heart failure patients were significant higher after one week treatment.But no significant difference between the patients with NYHA class II and NYHA class III-IV heart function before and after the treatment has been observed.Conclusion Therefore,the improvement of heart failure after one week of standard treatment could affect the expression of TIMP-1.And the change of the level of TIMP-1 in heart failure patients’ blood could reflect the effects of the treatment of heart failure.