慢性心衰患者年龄与端粒及心肌胶原的相关性研究

Correlation between aging and telomere and myocardial collagen in patients with chronic heart failure

目的 探讨衰老与慢性心衰心肌纤维化的相关性及其可能机制。方法 将100例心脏病患者分为非心衰（心功能Ⅰ级）组50例,心衰（心功能Ⅱ~Ⅳ级）组50例。采用RT-PCR法检测外周血白细胞中端粒长度,应用ELISA方法检测血清中PⅠCP、PⅢNP的浓度,并行相关性分析。结果 （1）心衰组血清PⅠCP、PⅢNP含量较非心衰组均明显增高（P〈0.05）;血清中PⅠCP、PⅢNP含量与心功能分级均呈显著正相关（P〈0.05）。（2）心衰组端粒长度较非心衰组明显缩短（P〈0.01）;端粒长度与心功能分级呈显著负相关（P〈0.05）。（3）心衰组及非心衰组血清中PⅠCP、PⅢNP含量均与年龄呈显著正相关（P〈0.05）;（4）两组端粒长度均与年龄呈显著负相关（P〈0.05）。（5）心衰组端粒长度与血清PⅠCP、PⅢNP浓度均呈显著负相关（P〈0.01）。结论 血清PⅠCP、PⅢNP浓度及端粒的长度与心功能密切相关,增龄（衰老）是心肌胶原增加及端粒缩短的独立危险因素,在慢性心衰心肌纤维化的发生、发展中起重要作用。

Objective To discuss the correlation between aging and myocardial fibrosis in patients with heart failure （HF） and the possible mechanism. Methods 100 patients with heart diseases were divided into non heart failure group （level 1 of heart function, 50 cases） and heart failure group （level 2-4 of heart function, 50 cases）. RT-PCR method was adopted to detect the middle telomere length of peripheral blood leucocyte. LISA was carried out to test the concentration of PⅠ CP, PⅢ NP in the serum. Correlation analysis was also carried out. Results （1） The concentration of serum P Ⅱ CP and pⅢNP in heart failure group increased significantly compared with that in the non heart failure group （P 〈 0.01）. There was a significantly positive correlation between the PⅠ CP and P Ⅲ NP content in serum and the cardiac functional grading （P 〈 0.05）. （2） The middle telomere length significantly shortened in the heart failure group compared with that in the non heart failure group （P 〈 0.01）. There was a significantly negative correlation between the telomere length and the cardiac functional grading （P 〈 0.05）. （3） There was a significantly positive correlation between the serum PⅠ CP and P Ⅲ NP content and the age in the both groups. （4） There was a significantly negative correlation between the telomere length and the age in both groups （P 〈 0.05）. （5） There was a significantly negative correlation between the telomere length and serum P Ⅰ CP and P Ⅲ NP concentration in the heart failure group. Conclusion Serum PⅠ CP and PⅢ NP concentration and telomere length are closed correlated with the heart function. Aging is the independent risk factor of myocardial collagen increase and the telomere length shortening, which plays an important role in the occurrence and development of myocardial fibrosis of heart failure.