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老年慢性心力衰竭患者外周血CD14dimCD16+单核细胞和血清C反应蛋白水平的变化

  • 周熙琳 ,
  • 梁辉
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  • 上海交通大学 医学院附属新华医院崇明分院老年科,上海 202150
周熙琳(1972—),女,副主任医师,硕士;电子信箱:zhou2xilin@163.com。

网络出版日期: 2017-03-30

基金资助

崇明县科委基金(CKY2013-08)

Changes in peripheral blood CD14dimCD16+ monocyte count and serum C- reactive protein level in elderly patients with chronic heart failure

  • ZHOU Xi-lin ,
  • LIANG Hui
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  • Department of Geriatrics, Chongming Branch of Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 202150, China

Online published: 2017-03-30

Supported by

The Science and Technology Funds of Chongming County,CKY2013-08

摘要

目的 ·观察老年慢性心力衰竭(CHF)患者外周血CD14dimCD16+单核细胞和C反应蛋白(CRP)水平的变化,分析其与患者心功能的关系。方法 ·选取42例老年CHF患者(CHF组:NYHAⅡ级18例,NYHAⅢ级18例,NYHAⅣ级6例)和25名健康老年人(对照组)作为研究对象,分别测定外周血CD14dimCD16+单核细胞和血清CRP水平、左室射血分数(LVEF)和左室舒张末期内径(LVEDD),并进行统计学分析。结果 · CHF组外周血CD14dimCD16+单核细胞和血清CRP水平均显著高于对照组(P<0.05)。在CHF组中,与NYHAⅡ级患者比较,NYHAⅣ级患者外周血CD14dimCD16+单核细胞和血清CRP水平及LVEDD均显著增高,而LVEF显著降低,差异均有统计学意义(P<0.05)。相关分析结果显示,CHF组外周血CD14dimCD16+单核细胞和血清CRP水平与LVEDD呈正相关(r=0.37,r =0.45,P<0.05),与LVEF呈负相关(r =-0.56,r =-0.33,P<0.05)。结论 ·老年CHF患者的病情加重与炎症有关,在心力衰竭的过程中可能存在单核细胞功能异常。外周血CD14dimCD16+单核细胞和血清CRP水平有望成为反映心力衰竭严重程度再分层的新型生物标志物。

本文引用格式

周熙琳 , 梁辉 . 老年慢性心力衰竭患者外周血CD14dimCD16+单核细胞和血清C反应蛋白水平的变化[J]. 上海交通大学学报(医学版), 2017 , 37(3) : 423 . DOI: 10.3969/j.issn.1674-8115.2017.03.030

Abstract

Objective · To observe the changes in peripheral blood CD14dimCD16+ monocyte count and serum C-reactive protein (CRP) level in elderly patients with chronic heart failure (CHF) and analyze the relationship between these changes and the cardiac function of patients. Methods · 42 elderly patients with CHF (the CHF group, consisting of 18 cases of NYHA cardiac function grade Ⅱ, 18 cases of NYHA cardiac function grade Ⅲ, and 6 cases of NYHA cardiac function grade Ⅳ) and 25 healthy elderly people (the control group) were enrolled. Peripheral blood CD14dimCD16+ monocyte count, serum CRP level, left ventricular ejection fraction (LVEF), and left ventricular end-diastolic diameter (LVEDD) were measured and statistical analysis was performed. Results · CD14dimCD16+ monocyte count and serum CRP level were significantly higher in the CHF group than in the control group (P<0.05). In the CHF group, the CD14dimCD16+ monocyte count, serum CRP level, and LVEDD of NYHA grade Ⅳ patients were significantly higher than those of NYHA grade Ⅱ patients, while their LVEF was remarkably lower than that of NYHA grade Ⅱ patients. The differences were statistically significant (P<0.05). Correlation analysis results showed that peripheral blood CD14dimCD16+ monocyte count and serum CRP level were positively correlated with LVEDD (r =0.37, r =0.45, P<0.05) and negatively correlated with LVEF (r=-0.56, r =-0.33, P<0.05) in the CHF group. Conclusion · The deterioration of elderly patients with CHF is associated with inflammation and the monocyte dysfunction may exist in the heart failure process. Peripheral blood CD14dimCD16+ monocyte count and serum CRP level are expected to be novel biomarkers that can reflect the severity of heart failure.
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