炎症因子TNF-α、IL-在慢性血栓栓塞性肺动脉高压患者中的表达及临床意义

徐键; 李乐; 黄艳丽; 桂金沭; 李娅红; 马蕾

doi:10.12259/j.issn.2095-610X.S20210631

炎症因子TNF-α、IL-在慢性血栓栓塞性肺动脉高压患者中的表达及临床意义

doi: 10.12259/j.issn.2095-610X.S20210631

昆明医科大学第一附属医院干部医疗科，云南昆明　650032

基金项目: 云南省教育厅科学研究基金资助项目（2020J0154）

详细信息

作者简介:
徐键（1983～），男，云南宣威人，医学硕士，主治医师，主要从事呼吸系统疾病研究工作

通讯作者:
马蕾，E-mail：2503299557@qq.com

中图分类号: R543.2
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出版历程
- 收稿日期: 2021-03-27
- 网络出版日期: 2021-06-16
- 刊出日期: 2021-07-21

Expression of Inflammatory Cytokines TNF-α and IL-6 in Patients with Chronic Thromboembolic Pulmonary Hypertension and Their Clinical Significance

Dept. of Geriatrics，the First Affiliated Hospital of Kunming Medical University，Kunming Yunnan，650032，China

摘要

摘要: 目的检测慢性血栓栓塞性肺动脉高压（chronic thromboembolic pulmonary hypertension，CTEPH）患者血清中炎症因子TNF-α及IL-6的水平，探讨其在CTEPH中的临床意义。方法回顾性分析2015年1月至2020年1月于昆明医科大学第一附属医院就诊的CTEPH患者59例，根据超声心动图分为右心功能正常组（观察组1）、右心功能不全组（观察组2）。选取同期就诊符合条件的无肺动脉高压人群共30例作为对照组。检测血清中炎症因子TNF-α、IL-6及NT-proBNP的水平，超声心动图测量肺动脉收缩压（Pulmonary arterial systolic pressure，PASP）。结果对照组、观察组1、观察组2血清中TNF-α、IL-6、NT-proBNP浓度依次升高，TNF-α的浓度分别为（13.54±6.37）pg/mL、（25.20±11.87）pg/mL、（40.75±1.74）pg/mL，IL-6的浓度分别为（6.04±2.89）pg/mL、（8.56±4.25）pg/mL、（4.95±5.24）pg/mL，NT-proBNP的浓度分别为（265.07±132.47）pg/mL、（719.52±345.23）pg/mL、（1250.00±421.22）pg/mL，各组间TNF-α、IL-6、NT-proBNP差异有统计学意义（P < 0.05）。PASP亦依次升高，分别为（32.07±6.15）mmHg、（57.04±11.26）mmHg、（73.22±11.79） mmHg，各组间差异有统计学意义（P < 0.05）。相关分析显示TNF-α、IL-6的水平与NT-proBNP、PASP呈显著相关（P < 0.05）。结论 CTEPH高压患者中存在炎症因子TNF-α、IL-6的高表达，且其表达水平可反应右心功能、肺动脉压。
- 慢性血栓栓塞性肺动脉高压 /
- 炎症因子 /
- 右心功能 /
- 肺动脉收缩压
Abstract: Objective To detect the serum levels of the inflammatory factors TNF-α and IL-6 in patients with chronic thromboembolic pulmonary hypertension （CTEPH） and further study their clinical significance in CTEPH. Methods A retrospective analysis was performed on 59 cases of CTEPH patients admitted to our hospital from January 2015 to January 2020. According to the echocardiography, the patients were divided into the group with normal right heart function （observation group 1） and the group with injured right heart function （observation group 2）. A total of 30 patients with no PH who met the standards were selected as the control group.Serum levels of inflammatory cytokines TNF-α, IL-6 and NT-proBNP were detected. Pulmonary artery systolic pressure （PASP） was measured by echocardiography. Results The serum concentrations of TNF-α, IL-6 and NT-proBNP in the control group, observation group 1 and observation group 2 increased successively. The concentrations of TNF-αwere （13.54±6.37） pg/mL, （25.20±11.87） pg/mL and （40.75±1.74） pg/mL, and the concentrations of IL-6 were （6.04±2.89）pg/mL, （8.56±4.25）pg/mL and（4.95±5.24）pg/mL, respectively.The concentrations of NT-proBNP were （265.07±132.47）pg/mL, （719.52±345.23）pg/mL and （1250.00±421.22） pg/mL respectively. There were significant differences in TNF-α, IL-6 and NT-proBNP between groups （P < 0.05）. PASP was also increased successively, which were （32.07±6.15）mmHg, （57.04±11.26）mmHg, and （73.22±11.79） mmHg, respectively. Correlation analysis showed that the levels of TNF-α, lL-6 were significantly correlated with NT-proBNP and PASP （P < 0.05）. Conclusion In patients with CTEPH hypertension, there are high expressions of inflammatory cytokines TNF- and IL-6, and their expression levels can reflect right heart function and pulmonary artery pressure.
- Chronic thromboembolic pulmonary hypertension /
- Inflammatory factors /
- Right heart function /
- Pulmonary arterial systolic pressure

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表 1 3组基础情况的比较[n（%）]

Table 1. Comparisons of basic conditions in different groups [n（%）]

基础情况	对照组（n = 30）	观察组1（n = 22）	观察组2（n = 37）	F/χ²	P
年龄（$\bar x \pm s $，岁）	64.63 ± 11.04	65.86 ± 9.17	60.62 ± 10.24	2.194	0.118
男性	21（70.00）	15（68.18）	26（70.27）	0.031	0.985
吸烟	12（40.00）	9（40.90）	15（40.54）	0.019	0.991
高血压	9（30.00）	7（31.82）	10（27.03）	0.167	0.924
糖尿病	8（26.67）	6（27.27）	9（24.32）	0.395	0.821
冠心病	7（23.33）	7（31.82）	8（21.62）	0.818	0.664
慢支炎	10（33.33）	9（40.91）	12（32.43）	0.481	0.786

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表 2 各组TNF-α、IL-6、NT-proBNP、PASP比较（$ \bar x \pm s$）

Table 2. Comparisons of TNF-α，IL-6，NT-proBNP，PASP in different groups （$ \bar x \pm s$）

分组	n	TNF-α（pg/mL）	IL-6（pg/mL）	NT-proBNP（ng/L）	PASP（mmHg）
对照组	30	13.54 ± 6.37	6.04 ± 2.89	265.07 ± 132.47	32.07 ± 6.15
观察组1	22	25.20 ± 11.87^*	8.56 ± 4.25^*	719.52 ± 345.23^*	57.04 ± 11.26^*
观察组2	37	40.75 ± 1.74^*△	14.95 ± 5.24^*△	1250.00 ± 421.22^*△	73.22 ± 11.79^{* △}
F		59.099	34.169	68.382	126.399
P		< 0.001	< 0.001	< 0.001	< 0.001
与对照组比较，^*P < 0.05，与组1比较，^△P < 0.05。

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表 3 TNF-α、IL-6与NT-proBNP、PASP的相关性分析

Table 3. Correlation analysis of TNF-α，IL-6 and NT-proBNP，PASP

检测项目	NT-proBNP		PASP
检测项目	r	P	r	P
TNF-α	0.852	< 0.001	0.814	< 0.001
IL-6	0.726	< 0.001	0.681	< 0.001

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参考文献(22)

[1]	Konstantinides S V,Meyer G,Becattini C,et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society(ERS)[J]. Eur Heart J,2020,41(4):543-603. doi: 10.1093/eurheartj/ehz405
[2]	Mehta S,Helmersen D,Provencher S,et al. Diagnostic evaluation and management of chronic thromboembolic pulmonary hypertension:a clinical practice guideline[J]. Can Respir J,2010,17(6):301-334. doi: 10.1155/2010/704258
[3]	中华医学会呼吸病学分会肺栓塞与肺血管病学组,中国医师协会呼吸医师分会肺栓塞与肺血管病工作委员会,全国肺栓塞与肺血管病防治协作组. 肺血栓栓塞症诊治与预防指南[J]. 中华医学杂志,2018,98(14):1060-1087. doi: 10.3760/cma.j.issn.0376-2491.2018.14.007
[4]	中华医学会心血管病学分会肺血管病学组,中华心血管病杂志编辑委员会. 中国肺高血压诊断和治疗指南2018[J]. 中华心血管病杂志,2018,46(12):933-962. doi: 10.3760/cma.j.issn.0253-3758.2018.12.006
[5]	Fujita M,Mason R J,Cool C,et al. Pulmonary hypertension in TNF alpha-overexpressing mice is associated with decreased VEGF gene expression.[J]. J Appl Physiol(1985),2002,93(6):2162-2170. doi: 10.1152/japplphysiol.00083.2002
[6]	Sakao S,Hao H,Tanabe N,et al. Endothelial-like cells in chronic thromboembolic pulmonary hypertension:crosstalk with myofibroblast-like cells[J]. Respir Res,2011,12(1):109. doi: 10.1186/1465-9921-12-109
[7]	沈和平,吴达文,陈云飞等. 肿瘤坏死因子一仪在慢性血栓栓塞性肺动脉高压大鼠模型肺血管重塑中的作用[J]. 中华结核和呼吸杂志,2018,41(8):632-637. doi: 10.3760/cma.j.issn.1001-0939.2018.08.012
[8]	endothelial -to-mesenchymal transition: potential contribution to vascular remodeling in chronic pulmonary hypertension[J]. Am J Physiol Lung Cell Mol Physiol, 2007, 293（1）: L1-L8.
[9]	Naito A,Sakao S,Terada J,et al. Nocturnal Hypoxemia and High Circulating TNF-α Levels in Chronic Thromboembolic Pulmonary Hypertension[J]. Intern Med,2020,59(15):1819-1826. doi: 10.2169/internalmedicine.4458-20
[10]	Langer F,Schramm R,Bauer M,et al. Cytokine response to pulmonary thromboendarterectomy[J]. Chest,2004,126(1):135-141. doi: 10.1378/chest.126.1.135
[11]	Wu D,Chen Y,Wang W,et al. The role of inflammation in a rat model of chronic thromboembolic pulmonary hypertension induced by carrageenan[J]. Ann Transl Med,2020,8(7):492. doi: 10.21037/atm.2020.02.86
[12]	Tamura Y,Phan C,Tu L,et al. Ectopic upregulation of membrane-bound IL6R drives vascular remodeling in pulmonary arterial hypertension[J]. Clin Investig,2018,128(5):1956-1970. doi: 10.1172/JCI96462
[13]	Davies R J,Holmes A M,Deighton J,et al. BMP type II receptor deficiency confers resistance to growth inhibition by TGF-β in pulmonary artery smooth muscle cells:role of proinflammatory cytokines[J]. Am J Physiol Lung Cell Mol Physiol,2012,302(6):L604-615. doi: 10.1152/ajplung.00309.2011
[14]	Ricard N,Tu L,Le hiress M,et al. Increased pericyte coverage mediated by endothelial-derived fibroblast growth factor-2 and interleukin-6 is a source of smooth muscle-like cells in pulmonary hypertension[J]. Circulation,2014,129(15):1586-1597. doi: 10.1161/CIRCULATIONAHA.113.007469
[15]	Steiner M K,Syrkina O L,KolliputI N,et al. Interleukin-6 overexpression induces pulmonary hypertension[J]. Circ Res,2009,104(2):236-244. doi: 10.1161/CIRCRESAHA.108.182014
[16]	hypertension and augments hypoxia-induced pulmonary hypertension in mice[J]. Chest, 2005, 128（6 Suppl）: 572S-573S.
[17]	Savale L,TU L,Rideau D,et al. Impact of interleukin-6 on hypoxia-induced pulmonary hypertension and lung inflammation in mice[J]. Respir Res,2009,10(1):6. doi: 10.1186/1465-9921-10-6
[18]	Humbert M,Monti G,Brenot F,et al. Increased interleukin-1 and interleukin-6 serum concentrations in severe primary pulmonary hypertension[J]. Am J Respir Crit Care Med,1995,151(5):1628-1631. doi: 10.1164/ajrccm.151.5.7735624
[19]	Florentin J, Zhao J, Tai Y Y, et al. Interleukin-6 mediates neutrophil mobilization from bone marrow in pulmonary hypertension[J]. Cell Mol Immunol, 2021, Online ahead of print.
[20]	Prins K W,Archer S L,Pritzker M,et al. Interleukin-6 is independently associated with right ventricular function in pulmonary arterial hypertension[J]. Heart Lung Transplant,2018,37(3):376-384. doi: 10.1016/j.healun.2017.08.011
[21]	Heresi G A,Aytekin M,Hammel J P,et al. Plasma interleukin-6 adds prognostic information in pulmonary arterial hypertension[J]. Eur Respir J,2014,43 (3):912-914. doi: 10.1183/09031936.00164713
[22]	Mazetto B M,Orsi F L,Barnabé A,et al. Increased ADAMTS13 activity in patients with venous thromboembolism[J]. Thromb Res,2012,130(6):889-893. doi: 10.1016/j.thromres.2012.09.009

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