转化生长因子α、核因子κB与老年心血管疾病患者心血管重构相关性研究

摘要

Objective To investigate the correlation of transforming growth factor-a(TGF-α),nuclear factor-κB (NF-κB) with carotid artery remodeling and cardiac remodeling in elderly patients with hypertension and elderly hypertensive patients with coronary heart disease(CHD).Methods The serum concentrations of TGF-o were measured by radioimmunoassay in 60 cases of elderly patients with hypertension,58 cases of elderly hypertensive patients with CHD and 36 cases of normal controls.NF-κB activation expression rate was detected using immunohistochemical method.Vascular ultrasound and cardiac ultrasound were used to detect carotid vascular remodeling and heart remodeling echocardiography.Results The TGF-o, NF-κB level of patients with hypertension and CHD were significantly higher than those of hypertension group and normal control group, the indexes of hypertension group were significantly higher than those of normal control group.In hypertension and CHD group, hypertension group and healthy group,TGF-α (25.83 + 9.38) ng/L vs (16.34±5.42) ng/L vs (6.83±2.53) ng/L,NF-κB (34.80±13.41)% vs (22.58 + 6.30)% vs (14.11±3.75)%.TGF-o serum level and peripheral blood mononuclear cell NF-κB activation rate were significantly positively correlated ( r =0.678, P <0.01).There were positive correlation among TGF-α,NF-kB levels and vascular remodeling indicators,which can be reflected by carotid artery diameter,intima-media thickness and vascular wall/cavity ratio, carotid artery plaque score, carotid artery resistance index and pulsatility index.TGF-o level was positively correlated with left ventricular diastolic diameter, thickness of the IVS, LV posterior wall and LVMI, those were indicators of cardiac remodeling.And TGF-o level also negatively correlated with EF,FS, which reflect the cardiac systolic function.NF-κB level and ventricular septal thickness, left ventricular mass index were positively correlated.The relationship between NF-κB level and EF values showed negative correlation.Conclusion Serum TGF-α level and peripheral blood monocyte NF-κB activation rate related.TGF-α possibly through NF-κB participates in the cell signal transduction.Both TGF-α and NF-κB are cardiovascular remodeling indexes of elderly cardiovascular disease and poor prognosis indicators.%目的 探讨转化生长因子α(TGF-α)、核因子κB(NF-κB)在老年高血压患者及老年高血压合并冠心病患者颈动脉重构及心脏重构中的意义.方法 放射免疫法测定60例老年高血压患者、58例老年高血压合并冠心病患者和36例正常对照者血清TGF-α的浓度.免疫组织化学方法检测 NF-κB活化表达率.血管超声及心脏超声检测颈动脉血管重构及心脏重构指标.结果 高血压合并冠心病组TGF-α、NF-κB水平明显高于高血压组和正常对照组,高血压组显著高于正常对照组.高血压合并冠心病组、高血压组、正常对照组分别为TGF-α(25.83±9.38)ng/L vs(16.34±5.42)ng/L vs(6.83±2.53)ng/L,NF-κB (34.80±13.41)％vs (22.58±6.30)％ vs (14.11±3.75)％.血清TGF-α水平与外周血单个核细胞NF-κB活化率呈显著正相关(r=0.678,P＜0.01).TGF-α,、NF-κB水平与颈动脉内径、内膜-中层厚度、血管壁/腔比值、颈动脉斑块积分、颈动脉阻力指数、搏动指数等反映血管重构的指标呈正相关.TGF-α水平与反映心脏重构指标左心室舒张末期容积、室间隔、左心室后壁厚度、左心室质量指数呈正相关；与反映心脏收缩功能指标射血分数(EF)、左心室短轴缩短率(FS)值呈负相关.NF-κB水平与室间隔厚度、左心室质量指数呈正相关；与EF值呈负相关.结论 血清TGF-α水平与外周血单个核细胞NF-κB活化率相关,TGF-α可能通过NF-κB参与细胞信号传导.TGF-α、NF-κB水平与颈动脉、心脏重构相关,为老年心血管疾病的心血管重构及不良预后的指标.