老年慢性心力衰竭患者外周血CD14^(dim)CD16^+单核细胞及白介素-13水平与心功能的关系

Study on relationship between levels of peripheral blood CD14^(dim)CD16^+ monocytes,interleukin-13 and cardiac function in elderly patients with chronic heart failure

目的:研究老年慢性心力衰竭(CHF)患者外周血CD14^(dim)CD16^+单核细胞数和血清白介素-13(IL-13)的水平及其与心功能之间的关系。方法:选取42例老年CHF患者为观察组,另选25名健康老年人为对照组,采用流式细胞术检测外周血单核细胞CD14^(dim)CD16^+表达,采用酶联免疫吸附法(ELISA)检测血清IL-13水平变化,同时采用超声心动图测定左心室射血分数(LVEF)和舒张末期内径(LVEDD)。结果:老年CHF组CD14^(dim)CD16^+单核细胞数高于健康对照组(P<0.05),与IL-13水平呈正相关(r=0.51,P<0.05)。随着心功能的恶化,CD14^(dim)CD16^+单核细胞数与IL-13水平逐渐升高,两者水平与LVEDD呈正相关(r=0.37,r=0.42,P<0.05),与LVEF呈负相关(r=-0.56,r=-0.45,P<0.05)。结论:老年CHF患者体内存在单核细胞功能异常,CD14^(dim)CD16^+水平和血清IL-13浓度有望成为反映心力衰竭严重程度再分层的一种新型生物标志物。

Objective To investigate the relationship between levels of peripheral blood CD14^dimCD16^＋ monocytes, interleukin 13（IL-13） and cardiac function in elderly patients with chronic heart failure（CHF）. Methods Forty two elderly patients with CHF were enrolled in this study and 25 cases of healthy elderly people were served as controls. The number of CD14^dimCD16^＋monocytes was measured by flow cytometry, and the level of serum IL-13 level was detected by enzymelinked immunosorbent assay（ELISA）. The left ventricular ejection fraction（LVEF） and left ventricular end diastolic diameter（LVEDD） were determined by echocardiography. Results The number of CD14^dimCD16^＋ monocytes in CHF group was significantly higher than that of control group（P〈0.05） and was positively correlated with serum IL-13 level（r=0.54, P〈0.05）. The number of CD14^dimCD16^＋ monocytes and the level of IL-13 increased gradually as the cardiac function deteriorated（P〈0.05）, and both the number of CD14dimCD16＋monocytes and the level of IL-13 were positively correlated with LVEDD（r =0.37, r =0.42, P 〈0.05）and negatively correlated with LVEF（r =-0.56, r =-0.45, P 〈0.05）. Conclusions Monocyte function abnormality might exist in elderly patients with CHF, and the levels of CD14^dimCD16^＋ monocytes and serum IL-13 are expected to be the new biomarkers reflecting the severity of heart failure.