血浆NLRC4和IL–1β水平变化与慢性心力衰竭炎症反应的相关性分析

王聪; 邹仕英; 耿嘉逸; 丁洋洋; 高琦; 张恒; 康品方; 唐碧

血浆NLRC4和IL–1β水平变化与慢性心力衰竭炎症反应的相关性分析

Correlation analysis of plasma NLRC4 and IL–1β levels with inflammatory response in chronic heart failure

摘要

摘要:
目的： 分析慢性心力衰竭（CHF）病人血浆中核苷酸结合寡聚化结构域样受体蛋白4（NLRC4）)和白细胞介素–1β（Interleukin–1β，IL–1β）的水平变化，探讨炎症反应与CHF发生、发展的关系。
方法： 选取165例CHF病人作为CHF组，其中NYHA分级Ⅱ级45例、Ⅲ级组63例、Ⅳ级57例；以同期健康体检者35名作为对照组。采用ELISA检测血浆中IL–1β和NLRC4水平，通过Western blotting检测NLRC4、IL–1β蛋白表达。分析CHF病人NLRC4、IL–1β、N末端脑钠肽前体（NT–proBNP）、左心室射血分数（LVEF）、左心室舒张末期内径（LVEDD）、左室舒张末期容积（LVEDV）间的相关性，以及NLRC4、IL–1β对CHF的诊断价值。
结果： CHF组NLRC4、IL–1β、NT–BNP、LVEDD、LVEDV均明显高于对照组，LVEF明显低于对照组（P ＜ 0.01）。Pearson相关分析显示，CHF病人NLRC4、IL–1β水平与NT–proBNP、LVEDD、LVEDV均呈明显正相关关系（P ＜ 0.01），与LVEF呈明显负相关关系（P ＜ 0.01），NLRC4与IL–1β呈明显正相关关系（P ＜ 0.01）。ROC曲线分析显示，NLRC4、IL–1β诊断CHF的AUC分别为0.817、0.858。Spearman相关分析显示，CHF病人NLRC4和IL–1β的表达量与心功能分级均呈明显正相关关系，并呈逐级递增趋势（P ＜ 0.01）。Western blotting结果显示，与对照组比较，心功能Ⅱ、Ⅲ、Ⅳ级组NLRC4、IL–1β表达量均增加（P ＜ 0.01）；与Ⅱ级组相比，心功能Ⅲ、Ⅳ级组NLRC4、IL–1β表达量增加（P ＜ 0.01）；与Ⅲ级组相比，心功能Ⅳ级组NLRC4、IL–1β表达量增加（P ＜ 0.01）。
结论： CHF病人血浆中NLRC4和IL–1β升高，与CHF的严重程度呈正相关，其诱导的炎症反应在CHF病情发展中发挥一定作用。

Abstract:
Objective To detect the plasma levels of NOD-like receptor family pyrin domain-containing protein 4 (NLRC4) and Interleukin-1β (IL-1β) in patients with Chronic Heart Failure (CHF), and explore the relationship between inflammatory response and occurrence and development of CHF.
Methods A total of 165 patients with CHF were selected as CHF group (including 45 patients in NYHA grade Ⅱ, 63 patients in grade Ⅲ and 57 patients in grade Ⅳ), and 35 healthy subjects in the same period were set as control group. The plasma levels of IL-1β and NLRC4 were detected by ELISA, and the protein expression levels of NLRC4 and IL-1β were detected by Western blotting. The correlations among NLRC4, IL-1β, NT-proBNP, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), and left ventricular end-diastolic volume (LVEDV) in CHF patients were analyzed, and the diagnostic value of NLRC4 and IL-1β in CHF patients were investiagted.
Results The NLRC4, IL-1β, NT-BNP, LVEDD and LVEDV levels in the CHF group were significantly higher than those in control group, and the LVEF was significantly lower than that in control group (P ＜ 0.01). The results of Pearson correlation analysis showed that the NLRC4 and IL-1β levels in CHF patients were significantly positively correlated with NT-proBNP, LVEDD and LVEDV (P ＜ 0.01), and significantly negatively correlated with LVEF (P ＜ 0.01). The NLRC4 was positively correlated with IL-1β (P ＜ 0.01). The results of ROC curve analysis showed that the AUC of NLRC4 and IL-1β for the diagnosis of CHF were 0.817 and 0.858, respectively. The results of Spearman correlation analysis showed that the expression levels of NLRC4 and IL-1β in CHF patients were positively correlated with the cardiac function grade, and showed a gradual increasing trend (P ＜ 0.01). The results of Western blotting results showed that compared with the control group, the expressions of NLRC4 and IL-1β in cardiac function grade Ⅱ, Ⅲ and Ⅳ groups increased (P ＜ 0.01). Compared with grade Ⅱ group, the expression levels of NLRC4 and IL-1β in cardiac function grade Ⅲ and Ⅳ groups increased (P ＜ 0.01). Compared with garde Ⅲ group, the expression levels of NLRC4 and IL-1β in grade Ⅳ group increased (P ＜ 0.01).
Conclusions The increasing of plasma levels of NLRC4 and IL-1β in patients with CHF is positively correlated with the severity of CHF, and the induced inflammatory response plays a certain role in the progressive development of CHF.

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