缺血性心肌病患者淋巴细胞PPAR-α与心室重构及心功能的相关性研究

PPAR-αexpression in lymphocytes of patients with ischemic cardiomyopathy and its corre- lation with cardiac functional

目的:检测缺血性心肌病患者淋巴细胞过氧化物酶体增生激活型受体α(PPAR-α)的表达,并探讨其与心室重构及心功能状态的关系。方法:选择97例经冠状动脉造影、心脏彩超结合临床资料明确诊断的缺血性心肌病患者,根据纽约心功能分级:心功能Ⅰ级24例,Ⅱ级25例,Ⅲ级25例,Ⅳ级23例,选择冠脉造影正常、心功能正常的25例非冠心病患者作为对照组,分离周围血淋巴细胞,以ELISA法测定其淋巴细胞膜中的PPAR-α水平,以彩色多普勒超声心动图测定左室内径大小(LVD)、舒张末容积(EDV)及射血分数(EF),比较PPAR-α与左室重构和心功能的关系。结果:缺血性心肌病患者的PPAR-α表达水平较对照组显著下降[(41.65±8.92)pg/mL vs(55.32±6.89)pg/mL)];相关分析显示,缺血性心肌病患者PPAR-α的表达水平与左室内径、舒张末容积呈负相关﹙=-0.535,r=-0.672,P均<0.01﹚,与纽约心功能分级和EF值无明显相关。结论:缺血性心肌病患者外周血淋巴细胞中PPAR-α的表达下调,左室重构愈明显PPAR-α的表达下调越显著;PPAR-α的表达与纽约心功能分级和心脏射血分数无关,PPAR-α可能具有抗心肌重构的作用。

Objective. To investigate the level of PPAR-a in peripheral blood lymphocytes from pa- tients with ischemic cardiomyopathy （ICM）, and the correlation between PPAR- and ventricular remode- ling g, cardiac function. Methods： A total of 97 cases of ischemic cardiomyopathy （ICM） were randomly di- vided into I -IV class by NYHA class. The class I had 24 cases, class 1I had 25 cases, class ]]] had 25 ca- ses and class Ivhad 23 cases. A total of 25 healthy people were enrolled as control group. PPAR-a expres- sion in lymphocytes was measured by ELISA, and left ventricular end （LVD）, end-systolic volume （ESV） and left ventricular ejection fraction （LVEF） were determined by color Doppler echocardiography. Results： Expression of PPAR-a in peripheral lymphocytes of ICM group was lowered compared to that of control group [（41.65-t-8.92） pg/mL vs （55.32-t-6.89） pg/mL] PPAR-a expression has negative correlation