硫氧还蛋白相互作用蛋白和炎症小体在慢性心力衰竭中的应用价值

The application value of thioredoxin-interacting protein and inflammasome 3 in chronic heart failure

目的:分析硫氧还蛋白相互作用蛋白(TXNIP)、炎症小体3(NLRP3)与心力衰竭(心衰)患者再住院率、活动耐量间的关系。方法:入选患者分为对照组(60例)、射血分数保留组(50例)、射血分数中间组(50例)和射血分数降低组患者(40例)。检测各组患者血浆中TXNIP、NLRP3、BNP的表达水平;记录患者心脏彩超、6 min步行试验结果。分析血清中TXNIP、NLRP3的表达水平是否和心脏功能、患者活动耐力和心衰的再入院率相关。结果:各组年龄和基础病史间无明显差异。随访期间随着射血分数的减低和患者活动耐力降低,血清中TXNIP和NLRP3的表达水平明显升高(P<0.001)。回归分析显示TXNIP和NLRP3是心衰患者再发住院的独立危险因素(P<0.001)。TXNIP和NLRP3预测心衰患者再住院曲线下面积分别为0.815、0.882。结论:TXNIP和NLRP3的表达水平随射血分数和活动耐量的减低逐渐增加,TXNIP和NLRP3是可用于心衰患者再入院的预测因素。

Objective To analyze the roles of thioredoxin interacting protein(TXNIP)and inflammatory body 3(NLRP3)in patients with heart failure(CHF).Methods The patients were divided into control group(60 cases),ejection fraction retention group(50 cases),intermediate ejection fraction group(50 cases)and reduced ejection fraction group(40 cases).The expression levels of TXNIP,NLRP3 and BNP in plasma were detected.The results of heart color ultrasound and 6 min walking test were recorded.The TXNIP and NLRP3 in serum were detected.Results During the follow-up period,the expression levels of TXNIP and NLRP3 increased significantly with the decrease of ejection fraction and activity endurance(P<0.001).Regression analysis showed that TXNIP and NLRP3 were independent risk factors for rehospitalization in patients with heart failure(P<0.001).The area under curve of TXNIP and NLRP3 in ROC curve were 0.815 and 0.882,respectively.Conclusion The expression levels of TXNIP and NLRP3 increased with the decrease of ejection fraction and activity tolerance,and TXNIP and NLRP3 could be used as predicators of readmission in patients with heart failure.