肿瘤坏死因子相关调亡诱导配基在肺动脉高压中的表达与临床意义

The expression and clinical significance of TRAIL in pulmonary artery hypertension

目的:探索肿瘤坏死因子相关调亡诱导配基(TRAIL)在肺动脉高压(PAH)中的表达及其临床意义。方法:入选2009年至2012年间就诊于瑞金医院门诊或住院部的患者82例,分为2组,心脏彩超检查诊断为PAH的患者27例作为PAH组,非PAH患者55例作为对照组。用ELISA法测定其血清TRAIL水平,结合世界卫生组织功能分级(WHO-FC)和六分钟步行距离(6MWD)等临床资料进行统计学分析。结果:与对照组相比较,PAH患者的血清TRAIL水平显著增高[(131.20±60.44)pg/mL比(77.28±26.84)pg/mL,P<0.001]。在PAH组中,血清TRAIL水平,①WHO-FCⅢ级和Ⅳ级的患者明显高于WHO-FCⅠ级和Ⅱ级者[(155.25±49.93)pg/mL比(74.08±43.12)pg/mL,P<0.001)];②与6MWD呈线性相关(r=-0.544,P=0.044),而与肺动脉收缩压(PASP)间无相关性。结论 :PAH患者血清TRAIL明显升高,且与疾病的严重程度相关。

Objective： To investigate the expression and clinical significance of tumor necrosis factor-related apoptosis-inducing ligand （TRAIL） in pulmonary arterial hypertension （PAH）. Methods： Eighty-two patients from outpatient or inpatient department of Ruijin hospital from 2009 to 2012 were enrolled and stratified into 2 groups： PAH group, 27 patients diagnosed by echocardiography; control group, 55 non-PAH patients. Serum TRAIL was assessed by EL｜SA and the results were analyzed with the World Health Organization （WHO） functional classification （WHO - FC） and six minutes walking distance （6 MWD）. Results： Level of TRAIL in PAH group was significantly higher than that of the control group [（131.20±60.44） pg/mL vs （77.28±26.84） pg/mL, P=0.O00）]. In PAH group, serum TRAIL level in the WHO FC m and 1V was significantly higher than that of I and lI [（155.25±49.93） pg/mL vs （74.08±43.12） pg/mL, P〈0.001）]. There was a linear correlation （r=-0.544, P=0.044） between level of serum TRAIL and 6 MWD, but no significant correlation was seen with pulmonary artery systolic pressure （PASP）. Conclusions： Serum TRAIL increases significantly in PAH patients and correlates with the severity of disease.