病毒性心肌炎患儿血清炎性细胞因子和高迁移率族蛋白1水平变化
|
摘要
目的观察病毒性心肌炎患儿血清转化生长因子-β1(TGF-β1)、肿瘤坏死因子-α(TNF-α)和高迁移率族蛋白1(HMGB1)水平变化,探讨临床意义。方法选择我科收治的病毒性心肌炎患儿共96例,根据其病程分为急性期组、恢复期组,各48例。另选择40名同期健康体检儿童为对照组。采用双抗体夹心酶联免疫分析法定量检测各组患儿血清TGF-β1、TNF-α和HMGB1水平。结果与对照组比较,急性期组的TGF-β1、HMGB1升高,TNF-α升高更显著(P<0.01),恢复期组TGF-β1较急性期稍低,但差异无统计学意义(P>0.05);TNF-α、HMGB1明显低于急性期组,仍高于对照组(P<0.05)。TGF-β1第3d、7d无显著变化,第14d时明显降低(P<0.05);TNF-α和HMGB1第3d、7d、14d依次降低,各时间点间差异有统计学意义(P<0.05)。结论病毒性心肌炎急性期炎性因子升高,恢复期虽降低,但仍存在心肌纤维化的危险,联合检测病毒性心肌炎患儿血清TGF-β1、TNF-α和HMGB1有助于病情判断及预后评估。
Objective To observe the changes of serum transforming growth factor-beta1(TGF-β1),tumor necrosis factor-alpha(TNF-α)and high mobility group protein 1(HMGB1)in children with viral myocarditis,and to explore the clinical significance.Methods Ninety six cases of viral myocarditis in our department were selected.According to their course of disease,they were divided into acute phase group and recovery stage group,with 48 cases in each group.Another 40 healthy children in the same period were selected as control group.The serum levels of TGF-β1,TNF-αand HMGB1 were detected by double antibody sandwich enzyme-linked immunosorbent assay.Results Compared with the control group,the TGF-β1 and HMGB1 increased in the acute stage and the increase of TNF-αwas more significant(P<0.01).The TGF-β1 in the recovery period was slightly lower than that in the acute stage,but the difference was not statistically significant(P>0.05).TNF-αand HMGB1 were significantly lower than those in the acute phase group,but still higher than those in the control group(P<0.05).There was no significant change in TGF-β1,3 dand 7 d,and decreased significantly at 14 d(P<0.05);TNF-αand HMGB1 3 d,7 d,14 ddecreased in turn,and there was a statistically significant difference between each time point(P<0.05).Conclusion The inflammatory factors in the acute stage of viral myocarditis are elevated,although the recovery period is reduced,but there is still a risk of myocardial fibrosis.The combined detection of serum TGF-β1,TNF-αand HMGB1 in children with viral myocarditis can help to the judge the disease and evaluate the prognosis.
Objective To observe the changes of serum transforming growth factor-beta1(TGF-β1),tumor necrosis factor-alpha(TNF-α)and high mobility group protein 1(HMGB1)in children with viral myocarditis,and to explore the clinical significance.Methods Ninety six cases of viral myocarditis in our department were selected.According to their course of disease,they were divided into acute phase group and recovery stage group,with 48 cases in each group.Another 40 healthy children in the same period were selected as control group.The serum levels of TGF-β1,TNF-αand HMGB1 were detected by double antibody sandwich enzyme-linked immunosorbent assay.Results Compared with the control group,the TGF-β1 and HMGB1 increased in the acute stage and the increase of TNF-αwas more significant(P<0.01).The TGF-β1 in the recovery period was slightly lower than that in the acute stage,but the difference was not statistically significant(P>0.05).TNF-αand HMGB1 were significantly lower than those in the acute phase group,but still higher than those in the control group(P<0.05).There was no significant change in TGF-β1,3 dand 7 d,and decreased significantly at 14 d(P<0.05);TNF-αand HMGB1 3 d,7 d,14 ddecreased in turn,and there was a statistically significant difference between each time point(P<0.05).Conclusion The inflammatory factors in the acute stage of viral myocarditis are elevated,although the recovery period is reduced,but there is still a risk of myocardial fibrosis.The combined detection of serum TGF-β1,TNF-αand HMGB1 in children with viral myocarditis can help to the judge the disease and evaluate the prognosis.
引文
[1]张教国,黄友敏,周永勤,等.病毒性心肌炎患儿血清高迁移率蛋白-1和内脂素水平的变化[J].中华临床医师杂志(电子版),2011,5(13):3933.
[2]华敏,黄友敏,周永勤.病毒性心肌炎患儿血清高迁移率蛋白-1和血管内皮细胞钙黏蛋白的变化[J].中国综合临床,2011,27(8):880.
[3]王德坤,魏汉维,彭戬.丹参酮ⅡA对病毒性心肌炎小鼠血清炎性因子水平的影响[J].中国中医急症,2016,25(5):766.
[4]罗进光,张嘉宁,王智彬,等.参麦注射液与曲美他嗪和左卡尼汀联合治疗急性病毒性心肌炎的临床疗效及对血清TNF-α和IL-6水平的影响[J].中华医院感染学杂志,2017,27(3):576.
[5]顾坚,鲍琼,张仕超,等.左卡尼汀对儿童病毒性心肌炎白介素-18及诱导型一氧化氮合酶的影响[J].儿科药学杂志,2014,20(2):5.
[6]罗进光,张嘉宁,王智彬,等.参麦注射液与曲美他嗪和左卡尼汀联合治疗急性病毒性心肌炎的临床疗效及对血清TNF-α和IL-6水平的影响[J].中华医院感染学杂志,2017,27(3):576.
[7]Sun XH,Fu J,Sun DQ.Halofuginone alleviates acute viral myocarditis in suckling BALB/c mice by inhibiting TGF-β1[J].Biochem Biophys Res Commun,2016,473(2):558.
[8]Hua JY,Zhang ZC,Jiang XH,et al.Relationship between endothelial-to-mesenchymal transition and cardiac fibrosis in acuteviral myocarditis[J].Zhejiang Da Xue Xue Bao Yi Xue Ban,2012,41(3):298.
[9]Zhang YY,Li JN,Xia HH,et al.Protective effects of losartan in mice with chronic viral myocarditis induced by coxsackievirus B3[J].Life Sci,2013,92(24-26):1186.
[10]Wang H,Gao P,Jing L,et al.The heart-protective mechanism of nitronyl nitroxide radicals on murine viral myocarditisinduced by CVB3[J].Biochimie,2012,94(9):1951.
[2]华敏,黄友敏,周永勤.病毒性心肌炎患儿血清高迁移率蛋白-1和血管内皮细胞钙黏蛋白的变化[J].中国综合临床,2011,27(8):880.
[3]王德坤,魏汉维,彭戬.丹参酮ⅡA对病毒性心肌炎小鼠血清炎性因子水平的影响[J].中国中医急症,2016,25(5):766.
[4]罗进光,张嘉宁,王智彬,等.参麦注射液与曲美他嗪和左卡尼汀联合治疗急性病毒性心肌炎的临床疗效及对血清TNF-α和IL-6水平的影响[J].中华医院感染学杂志,2017,27(3):576.
[5]顾坚,鲍琼,张仕超,等.左卡尼汀对儿童病毒性心肌炎白介素-18及诱导型一氧化氮合酶的影响[J].儿科药学杂志,2014,20(2):5.
[6]罗进光,张嘉宁,王智彬,等.参麦注射液与曲美他嗪和左卡尼汀联合治疗急性病毒性心肌炎的临床疗效及对血清TNF-α和IL-6水平的影响[J].中华医院感染学杂志,2017,27(3):576.
[7]Sun XH,Fu J,Sun DQ.Halofuginone alleviates acute viral myocarditis in suckling BALB/c mice by inhibiting TGF-β1[J].Biochem Biophys Res Commun,2016,473(2):558.
[8]Hua JY,Zhang ZC,Jiang XH,et al.Relationship between endothelial-to-mesenchymal transition and cardiac fibrosis in acuteviral myocarditis[J].Zhejiang Da Xue Xue Bao Yi Xue Ban,2012,41(3):298.
[9]Zhang YY,Li JN,Xia HH,et al.Protective effects of losartan in mice with chronic viral myocarditis induced by coxsackievirus B3[J].Life Sci,2013,92(24-26):1186.
[10]Wang H,Gao P,Jing L,et al.The heart-protective mechanism of nitronyl nitroxide radicals on murine viral myocarditisinduced by CVB3[J].Biochimie,2012,94(9):1951.