重度心衰患者高迁移率族蛋白B1水平变化研究

Study on changes in levels of HMGB1 in patients with severe heart failure

目的探讨重度心力衰竭(CHF)患者高迁移率族蛋白B1(HMGB1)的水平变化及其临床意义。方法利用彩色超声诊断仪等测定按纽约心脏病协会分级为Ⅲ～Ⅳ级的心功能不全患者,将心脏扩大、射血分数(EF)<35%的63例患者纳入研究组;另选25例正常体检者作为对照组。所有研究对象采用酶联免疫吸附法测定HMGB1、肿瘤坏死因子α(TNF-α)和白介素1(IL-1)水平;用彩色多普勒超声测定左室射血分数(EF值)及二尖瓣血流峰值速度/左室舒张晚期峰值速度(E/A值)。结果 CHF患者的HMGB1、TNF-α和IL-1均明显高于对照组(P<0.05);HMGB1与心衰的严重程度正相关。结论 CHF患者HMGB1水平明显升高,HMGB1可能参与了心力衰竭的过程,并可作为预测心衰严重性的参考指标。

Objective To explore the clinical significance and changes in serum levels of HMGB1 in patients with severe heart failure. Methods Sixty three patients with enlarged heart, EF scores 〈 35 % and heart failure with functional grades III - IV （ according to NYHA＇s classification） were allocated in study group, and 25 healthy persons selected as control group. Serum levels of HMGB1, TNFα and interleukin 1 （IL - 1 ） were detected by ELISA. Left ventricular ejection fraction（EF） and peak velocity of blood flow through mitral valve/peak velocity of late diastolic stage （ E/A ratio） were detected by color Doppler ultrasound imaging. Results Serum levels of HMGB1, TNF - α and IL - 1 in patients with chronic heart failure were significantly higher than those of control group （ P 〈0.05 ） , and the serum level of HMGB1 was positively correla- ted with the severity of heart failure. Conclusion The serum level of HMGB1 was significantly elevated in patients with chronic heart failure, HMGB1 may possibly be participated in the process of development of heart failure, thus it can be used as a referential indicator for prediction of the severity of heart failure.