郑韵仪，曾庆春，詹琼，朱丁季，华经海，周浩斌，安冬琪，刘祖恒，赖文岩，许顶立



钙化性主动脉瓣疾病患者血清免疫球蛋白E水平的变化

郑韵仪，曾庆春*，詹琼，朱丁季，华经海，周浩斌，安冬琪，刘祖恒，赖文岩，许顶立

摘要

关键词心脏瓣膜疾病；动脉粥样硬化；免疫球蛋白E；肥大细胞；炎症

作者单位：510515 广东省广州市，南方医科大学南方医院 心内科

Alterated Serum Levels of Immunoglobulin E in Patients With Calcific Aortic Valve Disease

ZHENG Yun-yi,ZENG Qing-chun,ZHAN Qiong,ZHU Ding-ji,HUA Jing-hai,ZHOU Hao-bin,AN Dong-qi,LIU Zu-heng,
LAI Wen-yan,XU Ding-li.
Department of Cardiology,Nanfang Hospital,Southern Medical University,Guangzhou(510515),Guangdong,China
Corresponding Author:XU Ding-li,Email:dinglixu@fimmu.com

Abstract

Objective:To explore the relationship between serum levels of immunoglobulin E(IgE)and calcific aortic valve disease(CAVD)in relevant patients.

Methods:A total of 394 patients were enrolled in our study.Based on echocardiography presentation,the patients were divided into 2 groups:CAVD group,n=169 and Non-CAVD group,n=225.Serum levels of IgE were examined by chemiluminescence method.The IgE levels were compared between 2 groups and the relationship between serum IgE level and CAVD was analyzed.

Results:Serum levels of IgE in CAVD group was significantly higher than Non-CAVD group 113.30 IU/ml vs 63.76 IU/ml(P<0.05);multivariate logistic regression analysis confirmed above difference(P<0.05)and it also indicated that the alteration of surum IgE level is obviously related to CAVD occurrence.

Conclusion:Serum IgE level is obviously increased in CAVD patients.IgE is an independent biochemical indicator of CAVD,it may play the important role in CAVD pathogenesis.

Key words Heart valve diseases;Atherosclerosis;Immunoglobulin E;Mast cell;Inflammation

(Chinese Circulation Journal,2016,31:263.)

钙化性主动脉瓣疾病（CAVD）包括主动脉瓣钙化与钙化性主动脉瓣狭窄，是一种慢性进展性疾病，其病理生理改变主要表现为主动脉瓣进行性增厚钙化、活动受限、左心室流出道梗阻、心功能不全乃至心力衰竭[1]。组织病理学研究显示，早期CAVD的病变机制可能与动脉粥样硬化相类似，符合经典的“损伤应答假说”[2-4]，而晚期则与骨形成过程相类似[5-7]。

肥大细胞来源于造血干细胞，含有特定的胞质颗粒，其中贮存有炎症介质和细胞因子如糜蛋白酶、胰蛋白酶、组胺、肝素和肿瘤坏死因子α等。免疫球蛋白E（IgE）可特异性与肥大细胞膜表面Fc段高亲和力受体（FcεR I）结合导致肥大细胞激活，并释放各种炎症性介质和细胞因子等，从而导致动脉血管平滑肌增生和组织损伤[8]。已有研究报告，肥大细胞数量与主动脉瓣钙化严重程度密切相关，且主要分布在钙化灶周围[9]，推测在主动脉瓣钙化过程中可能起重要作用。IgE是肥大细胞最重要的激活因子，故探讨血清IgE水平与CAVD的关系具有重要的临床意义。本研究旨在分析血清IgE在CAVD患者和非CAVD（non-CAVD）患者中的水平，探讨血清IgE水平与CAVD的关系。……