血浆补体因子H相关蛋白2在先天性心脏病合并肺动脉高压儿童中的改变
摘要
目的探讨先天性心脏病(CHD)合并肺动脉高压(CHD-PAH)儿童血浆补体因子H相关蛋白2(CFH-R2)的改变及临床意义。方法 2015年6月到2016年12月,选取我院心内科和心外科收治的89例CHD患儿;选取同时期来我院体检的健康儿童40例作为对照组。收集所有入选研究对象的基线资料(包括年龄、性别、身高、体重、血压等);采用心导管测量CHD患儿肺动脉压,并根据肺动脉压值进行分组:无肺动脉高压组、轻度组、中度组、重度组;血浆CFH-R2水平采用酶联免疫吸附法进行测定;并比较各组间血浆CFH-R2水平差异。采用Pearson相关分析血浆CFH-R2水平与肺动脉压相关性。结果本次研究共纳入109例研究对象,其中对照组40例,CHD组患儿89例。两组年龄、性别构成、身高、体重、血压等比较无统计学差异(P>0.05)。CHD患儿无肺动脉高压组、轻度组、中度组、重度组血浆CFH-R2水平显著低于对照组,比较差异有统计学意义(P<0.05);CHD患儿中,无肺动脉高压组CFH-R2水平最高,重度组CFH-R2水平最低,差异比较有统计学意义(P<0.05)。Pearson相关分析表明,CHD患儿肺动脉压与血浆CFH-R2水平负相关(r=-0.638,P<0.05)。结论 CHD合并PAH患儿血浆CFH-R2水平显著降低,CFH-R2水平与肺动脉压呈负相关,有可能作为CHD合并PAH的生物学标志之一。
引文
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[12]昝琦,刘欣,逄越,等.补体C3结构与功能研究进展[J].中国免疫学杂志,2014,30(4):549-553.
[13]付金容,林国生,黎明江,等.补体C1抑制剂对缺血心肌补体C3合成及炎性反应的影响[J].海南医学,2013,24(21):3125-3127.
[14]钱琦,陈忠,马根山,等.瑞舒伐他汀对动脉粥样硬化斑块中补体因子H表达的影响[J].中国生化药物杂志,2011,32(6):458-462.
[15]Humbert M,Ghofrani HA.The molecular targets of approved treatments for pulmonary arterial hypertension[J].Thorax,2016,71(1):73-83.
[2]Engelfriet PM,Duffels MG,Moller T,et al.Pulmonary arterial hypertension in adults born with a heart septal defect:the Euro Heart Survey on adult congenital heart disease[J].Heart,2007,93(6):682-687.
[3]Parikh RV,Scherzer R,Nitta EM,et al.Increased levels of asymmetric dimethylarginine are associated with pulmonary arterial hypertension in HIV infection[J].AIDS,2014,28(4):511-519.
[4]刘丽华,李亚蕊.先天性心脏病伴肺动脉高压患儿血清基质细胞衍生因子1水平变化[J].临床儿科杂志,2013,(12):1151-1153.
[5]Opitz CF,Blindt R,Blumberg F,et al.Pulmonary hypertension:hemodynamic evaluation:hemodynamic evaluation recommendations of the Cologne Consensus Conference 2010[J].Dtsch Med Wochenschr,2010,135(Suppl 3):S78-S86.
[6]Bauer EM,Zheng H,Comhair S,et al.Complement C3 deficiency attenuates chronic hypoxia.induced pulmonary hypertension in mice[J].PLo S One,201l,6(12):e28578.
[7]Banmgartner H,Bonhoeffer P,de Groot NM,et al.ESC guidelines for the management of grown-up congenital heart disease(new version 2010)[J].Eur Heart J,2010,31(23):2915-2957.
[8]Mclaughlin VV,Archer SL,Badesch DB,et al.Acc F/AHA 2009expert consensu8 document on pulmonary hypertension a report of the American College of Cardiology Foundation Task Fore on Expert Consensus Documents and the American Heart Association developed in collaboration with the American College of Chest Physicians;American Thoracic Society,Inc.;and the Pulmonary Hypertension Association[J].J Am Coll Cardiol,2009,53(17):1573-1619.
[9]Lavoie JR,Ormiston ML,Perezlmt,et al.Proteomic analysis implieates translationally controlled tumor protein as a novel mediator of occlusive vascular remodeling in pulmonary arterial hypertension[J].Circulation,2014,129(21):2125-2135.
[10]张丽,丁耀东,万雅妮,等.156例自身免疫性疾病患者补体C1q检测结果分析及临床意义[J].实验与检验医学,2016,34(5):615-617,620.
[11]王纪霞,邢广群,丁冉冉,等.恶性高血压患者补体因子H测定及其意义[J].临床内科杂志,2014,31(11):745-747.
[12]昝琦,刘欣,逄越,等.补体C3结构与功能研究进展[J].中国免疫学杂志,2014,30(4):549-553.
[13]付金容,林国生,黎明江,等.补体C1抑制剂对缺血心肌补体C3合成及炎性反应的影响[J].海南医学,2013,24(21):3125-3127.
[14]钱琦,陈忠,马根山,等.瑞舒伐他汀对动脉粥样硬化斑块中补体因子H表达的影响[J].中国生化药物杂志,2011,32(6):458-462.
[15]Humbert M,Ghofrani HA.The molecular targets of approved treatments for pulmonary arterial hypertension[J].Thorax,2016,71(1):73-83.