Ⅳ型心肾综合征患者IL-35血浓度及药学意义的探讨

Serum level of indoxyl sulfate and its pharmacological significance in patients with typeⅣcardiorenal syndrome

目的检测Ⅳ型心肾综合征(Ⅳ-CRS)患者白细胞介素35(IL-35)的血清浓度,分析其与心肾受损指标之间的关系,探讨IL-35的药学意义。方法108例慢性肾脏病患者进行心肾临床常规检查包括血清IL-35浓度、血肌酐(SCr)、超敏C反应蛋白(hs-CRP),计算估计肾小球滤过率(eGFR);超声心动图检查室间隔厚度(IVST),左心室后壁厚度(LVPWT),左室射血分数(EF),二尖瓣舒张晚期血流速度(A)与二尖瓣舒展早期血流速度(E)的比值(A/E)。以IL-35作因变量,其他指标作自变量进行相关分析。结果血清IL-35水平:正常对照组为(110.32±27.60)pg·mL^(-1),非CRS组为(89.25±20.12)pg·mL^(-1),CRS组为(77.71±25.23)pg·mL^(-1),组间比较差异有统计学意义(P<0.05)。CRS患者的心脏改变:心肌肥厚占比33.3%,舒张功能异常占比78.2%,收缩功能异常占比38.4%。IL-35与IVST、LVPWT、A/E、hs-CRP成负相关关系;与eGFR、EF成正相关关系。结论慢性肾脏疾病患者的IL-35血清浓度与肾功能、心脏受损指标(如心肌肥厚、心室收缩和舒张功能不全等)成负相关,提示IL-35在Ⅳ-CRS中对心肾有保护作用,有望开发成治疗慢性肾脏疾病的候选生物制剂。

Objective To determine the serum level interleukin 35(IL-35)indices withⅣcardiorenal syndrome,and to explore the pharmacological significance of IL-35.Methods Totally 108 patients with chronic kidney disease(CKD)were recruited.The serum IL-35,serum of creatinine,high-sensitivity C-reactive protein,eGFR,Interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),left ventricular ejection fraction(EF),and the ratio of the late mitral valve diastolic blood flow velocity to the early mitral valve dilatation blood flow velocity(A/E)were detected.IL-35 was used as the dependent variable,and other indicators served as independent variables for the correlation analysis.Results The serum level of IL-35 of all patients in the CKD groups was obviously higher than that of the control group.The serum level of IL-35 was(110.32±27.60)pg·mL^(-1)in the control group,(89.25±20.12)pg·mL^(-1)in the non-CRS group,and(77.71±25.23)pg·mL^(-1)in the CRS group.The comparison between the groups was statistically significant(P<0.05).Changes in CRS patients covered 33.3%cardiac hypertrophy,78.2%abnormal diastolic function,and 38.4%abnormal systolic function inⅣcardiorenal syndrome.Significant negative correlation was detected among the serum IL-35 and IVST,LVPWT,A/E,and hs-CRP,while positive correlation with eGFR and EF.Conclusion IL-35 in CKD patients is negatively correlated with renal function and cardiac impairment indicators such as myocardial hypertrophy,ventricular systolic and diastolic dysfunction,suggesting that IL-35 may protect the heart and kidney in IV-CRS and can be used as candidate biologics for CKD.