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目的:研究老年慢性心力衰竭(CHF)患者外周血CD14~(dim)CD16~+单核细胞数和血清白介素-13(IL-13)的水平及其与心功能之间的关系。方法:选取42例老年CHF患者为观察组,另选25名健康老年人为对照组,采用流式细胞术检测外周血单核细胞CD14~(dim)CD16~+表达,采用酶联免疫吸附法(ELISA)检测血清IL-13水平变化,同时采用超声心动图测定左心室射血分数(LVEF)和舒张末期内径(LVEDD)。结果:老年CHF组CD14~(dim)CD16~+单核细胞数高于健康对照组(P<0.05),与IL-13水平呈正相关(r=0.51,P<0.05)。随着心功能的恶化,CD14~(dim)CD16~+单核细胞数与IL-13水平逐渐升高,两者水平与LVEDD呈正相关(r=0.37,r=0.42,P<0.05),与LVEF呈负相关(r=-0.56,r=-0.45,P<0.05)。结论:老年CHF患者体内存在单核细胞功能异常,CD14~(dim)CD16~+水平和血清IL-13浓度有望成为反映心力衰竭严重程度再分层的一种新型生物标志物。
Objective: To study the relationship between the level of CD14 ~ (+) CD16 ~ + monocytes and serum IL-13 in peripheral blood of elderly patients with chronic heart failure (CHF) and its relationship with cardiac function. Methods: Forty-two elderly patients with CHF were selected as the observation group and 25 healthy controls as the control group. The expression of CD14 (CD16 +) in peripheral blood mononuclear cells was detected by flow cytometry and the expression of CD16 (+) was detected by enzyme-linked immunosorbent assay ELISA was used to detect the level of serum IL-13. The left ventricular ejection fraction (LVEF) and end diastolic diameter (LVEDD) were measured by echocardiography. Results: The number of CD14 ~ (+) CD16 ~ + monocytes in elderly CHF group was significantly higher than that in healthy controls (P <0.05), and positively correlated with IL-13 level (r = 0.51, P <0.05). With the worsening of cardiac function, the number of CD14 ~ (+) CD16 ~ + monocytes and IL-13 levels gradually increased. The levels of CD14 ~ (dim) CD16 ~ + were positively correlated with LVEDD (r = 0.37, r = 0.42, LVEF was negatively correlated (r = -0.56, r = -0.45, P <0.05). CONCLUSIONS: In elderly patients with CHF, mononuclear cell dysfunction exists. CD14 ~ (+) CD16 ~ + level and serum IL-13 concentration are expected to become a new biomarker reflecting the severity of heart failure.