充血性心力衰竭患者血清抗碳酸酐酶Ⅱ和Ⅲ自身抗体检测的意义

摘要

Objective To determine serum anti-carbonic anhydrase Ⅱ and Ⅲ auto-antibodies,the level of antioxidants and cytokines in patients with congestive heart failure (CHF)by established methods,and to evaluate primarily the clinical significance. Methods The serum anti-carbonic anhydrase Ⅱ and Ⅲ auto-antibodies, erythrocyte sedimentation rate(ESR),the levels of 5 kinds of cytokines [like interleukin 2 (IL-2 )]and 5 kinds of antioxidants [like superoxide dismutase (SOD)]from 58 patients with CHF in recent 3 months to 1 year were determined.Results The level of serum anti-carbonic anhydrase Ⅱ auto-antibody in CHF patients was significantly higher than that in control group (P<0.05 ).The levels of SOD,glutathione peroxidase (GPx),catalase (CAT)and total antioxidant capacity (TAC)in CHF patients were significantly lower than those in control group (P<0.05),while methanedicarboxylic aldehyde (MDA)level was significantly higher than that in control group(P<0.05).There was no statistical significance on the levels of interleukin (IL-6 ),tumor necrosis factor-alpha (TNF-α)and interferon-gamma (IFN-γ)between CHF patients and control group (P>0.05 ),while IL-2 and interleukin 1 7 (IL-1 7 )levels were significantly higher than those in control group (P<0.05 ).Conclusions There may be autoimmune phenomenon in CHF patients.IL-2,IL-1 7 and antioxidant capacity may be used as the markers for the diagnosis of anti-carbonic anhydrase Ⅱ auto-antibody.%目的：使用已建立的方法检测充血性心力衰竭（CHF）患者血清中的抗碳酸酐酶Ⅱ和Ⅲ自身抗体、抗氧化物及细胞因子水平，初步评价其临床意义。方法选取58例3个月～1年前曾发生心肌梗死的CHF患者和58名健康对照者，测定其血清抗碳酸酐酶Ⅱ和Ⅲ自身抗体、红细胞沉降率（ESR）、超氧化物歧化酶（SOD）等5种抗氧化物和白细胞介素2（IL-2）等5种细胞因子的水平。结果 CHF患者血清抗碳酸酐酶Ⅱ自身抗体和ESR水平显著高于对照组（P＜0．05），SOD、谷胱甘肽过氧化物酶（GPx）、过氧化氢酶（CAT）和总抗氧化能力（TAC）显著低于对照组（P＜0．05），丙二醛（MDA）水平显著高于对照组（P＜0．05）。CHF患者血清的IL-2和白细胞介素17（IL-17）水平较对照组显著升高（P＜0．05），白细胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）和γ干扰素（IFN-γ）与对照组差异无统计学意义（P＞0．05）。结论 CHF患者可能存在自身免疫的现象，IL-2、IL-17和抗氧化能力的检测可能作为判断抗碳酸酐酶Ⅱ抗体出现的指标。