缺血性与扩张性心肌病终末期心肌白细胞介素-6mRNA表达与心功能参数间的关系

Correlation between the expression of interleukin-6 messenger-RNA in myocardium of end-stage cardiac failure and cardiac functional parameters in patients with ischemic and dilated cardiomyopathy

目的 在检测晚期心力衰竭患者心肌组织中白细胞介素 6 (IL 6 )mRNA表达的基础上 ,探讨IL 6mRNA与心功能参数间的关系 ,为揭示IL 6参与心力衰竭发生发展提供依据。方法 以Northern blot法检测 2 7例接受心脏移植患者 (缺血性心肌病 12例 ,扩张性心肌病 15例 )不同部位心肌组织中IL 6mRNA表达水平 ,并以线性回归比较IL 6mRNA与移植前血流动力学和超声心动参数间的关系。结果 所有患者心肌组织中均有IL 6mRNA表达 ,扩张性心肌病左心室IL 6mRNA表达水平高于缺血性心肌病 (P =0 .0 0 6 )。IL 6mRNA在左心室的表达水平与左心室射血分数负相关 (r =- 0 .6 2 ,P <0 .0 5 ) ,在左、右心房的表达水平与左心室舒张末内径正相关 (r=0 .70 ,P <0 .0 5 ;r=0 .93,P <0 .0 0 1) ,在右心室的表达水平与心排指数负相关 (r=- 0 .49,P <0 .0 5 ) ,在右心房的表达水平不但与肺血管阻力正相关 (r =0 .6 3 ,P <0 .0 5 ) ,也与左心室收缩末内径正相关 (r =0 .82 ,P <0 .0 0 1)。结论 晚期心力衰竭患者心肌组织中有IL 6mRNA表达 ,IL 6mRNA水平与部分心功能参数相关 ,提示IL

Objective Basing on the test of expression of interleukin 6 (IL 6) mRNA in myocardium of end stage cardiac failure,the study was done to elucidated the correlation between the levels of IL 6 mRNA in myocardium and cardiac functional parameters and to test the hypothesis that IL 6 may be involved in the pathogenesis of cardiac failure. Method The expression of IL 6 mRNA in myocardium of 27 patients undergoing heart transplantation,including 12 cases of ischemic cardiomyopathy and 15 cases of dialated cardiomyopathy,were detected by Northern blot analysis. The comparisons between the levels of IL 6 mRNA in different parts of myocardial tissue and their hemodynamic and echocardiogram parameters were done by linear regression,respectively. Results The expressions of IL 6 mRNA were detected in all samples. The IL 6 mRNA level in left ventricle of patients with dialated cardiomyopathy was significantly higher than that of patients with ischemic cardiomyopathy. The expression in left ventricle was inversely correlated with left ventricular ejection fraction( r =-0.62, P <0.05) ,the expressions in left and right atria were correlated with left ventricular end diastolic diameter( r =0.70, P <0.05, r =0.93, P <0.001),the expression in right ventricle was correlated inversely with cardiac index( r =-0.48, P <0.05), the expression in right ventricle was correlated with pulmonary vascular resistance ( r =0.63, P <0.05) and with left ventricular end systolic diameter( r =0.82, P <0.001) . Conclusion The study showed that IL 6 mRNA expressed in myocardial tissue from end stage of cardiac failure and the expression levels were correlated with some of cardiac functional parameters. All of them suggest that IL 6 maybe involved in the pathogenesis and development of cardiac failure.