【摘要】 目的探讨慢性心力衰竭患者血清白细胞介素(interleukin,IL)-23检测的临床意义及奥美沙坦治疗对IL-23的影响。方法将惠州市第六人民医院2012年1月至2015年1月收治的200例慢性心力衰竭患者,按随机数字表法随机分为心力衰竭组100例(B组)和奥美沙坦治疗组100例(C组),另设来我院体检的健康自愿者50名作为对照组(A组)。B组给予常规治疗,C组给予奥美沙坦治疗。电化学发光仪法检测治疗前、后血浆脑钠肽(brain natriuretic peptide,BNP)浓度;双抗体酶联免疫吸附(ELISA)法测定血清IL-23浓度、Ⅰ型前胶原氨基端肽(amino-terminal peptide of type I procollagen,PINP)和Ⅲ型前胶原氨基端肽(amino-terminal peptide of typeⅢprocollagen,PⅢNP)浓度;超声心动图检测治疗前、后左心室舒张末期内径(left ventricular enddiastolic diameter,LVEDD)和左心室射血分数(left ventricular ejection fraction,LVEF),分析IL-23与各指标的相关性。结果 B、C组治疗前血清IL-23、BNP、PⅠNP、PⅢNP浓度及LVEDD较A组升高,LVEF较A组降低,差异有统计学意义(P<0.01)。B、C组治疗后较治疗前各指标均有一定程度的改善,差异有统计学意义(P<0.01或P<0.05)。C组治疗后各指标均较B组治疗后改善明显,差异有统计学意义(P<0.01或P<0.05)。Pearson分析结果显示,IL-23与BNP、PⅠNP、PⅢNP及LVEDD呈正相关,IL-23与LVEF呈负相关,且相关性均具有统计学意义(P<0.01)。结论 IL-23可作为心力衰竭患者新的生物标记物,奥美沙坦干预后可降低患者血清IL-23浓度。更多还原

【Abstract】 Objectives To investigate the clinical significance of serum concentration of interleukin(IL)-23 in patients with chronic heart failure and the effects of olmesartan treatment on IL-23. Methods Totally 200 patients with chronic heart failure in the Sixth People’s Hospital of Huizhou from January 2012 to January 2015 were randomly divided into heart failure group(group B,n=100) and olmesartan treatment group(group C, n =100). Patients in group B received conventional therapy and patients in group C were given olmesartan treatment. Meanwhile, 50 healthy volunteers were selected as control group(group A). ECL instrument was used to detect serum concentrations of brain natriuretic peptide(BNP) before and after treatment; double antibody enzyme-linked immunosorbent(ELISA) was used to detect serum concentrations of IL-23, type I procollagen amino-terminal peptide(PINP) and type Ⅲ procollagen aminoterminal peptide(PⅢNP) before and after treatment; ultrasound cardiogram was used to detect left ventricular enddiastolic diameter(LVEDD) and left ventricular ejection fraction(LVEF) before and after treatment. Correlations of IL-23 with each indicator were analyzed. Results Before treatment, serum concentrations of IL-23, PINP, PⅢ NP,plasma concentrations of BNP and LVEDD in group B and C were significantly higher than those in group A, while LVEF was significantly lower(P<0.01). Each indicator in group B and C group after treatment had a certain degree of improvement than pretherapy, the differences were statistically significant(P <0.01 or P <0.05). Improvement of each indicator in group C was more evident than that in group B after treatment, the differences were statistically significant(P<0.01 or P< 0.05). Pearson analysis indicated that serum concentration of IL-23 was positively correlated with BNP,PINP, P Ⅲ NP and LVEDD, and negatively correlated with LVEF, the correlations were significant(P <0.01).Conclusions IL-23 can be used as a new biomarker in patients with heart failure, and olmesartan intervention can reduce serum concentration of IL-23.更多还原