灯盏花素注射液对急性肺栓塞患者TLR4/NF-κB通路和肺循环功能的影响

Effects of breviscapine injection on the TLR4/NF-κB pathway and pulmonary circulation function in patients with acute pulmonary embolism

摘要

目的 探讨灯盏花素注射液对急性肺栓塞（APE）患者Toll样受体4/核转录因子-κB（TLR4/NF-κB）通路和肺循环功能的影响。方法 105例APE患者随机分为常规组（52例）和试验组（53例）。常规组实施常规治疗,试验组在常规治疗基础上加用灯盏花素注射液联合治疗。比较2组患者治疗后的TLR4/NF-κB通路蛋白、炎症反应因子、内皮功能相关因子及肺循环功能。结果 治疗后,试验组患者TLR4、NF-κB蛋白水平,炎症反应相关因子单核细胞趋化蛋白-1（MCP-1）、巨噬细胞炎症蛋白-1α（MIP-1α）、白细胞介素-18（IL-18）、白细胞介素-33（IL-33）,内皮功能相关因子内皮细胞特异性分子-1（ESM-1）、血管细胞黏附分子-1（sVCAM-1）、可溶性血栓调节蛋白（sTM）、不对称二甲基精氨酸（ADMA）,与肺循环功能相关收缩期肺动脉压（sPAP）、舒张期肺动脉压（dPAP）、肺血管阻力（PVR）、通气/血流比（V/Q）均明显低于常规组（P<0.05）。试验组患者治疗后的TLR4、NF-κB蛋白水平与各炎症反应相关因子、内皮功能相关因子、肺循环功能相关指标均呈正相关（P<0.05）。结论 在常规治疗的基础上联用灯盏花素注射液,能减轻APE炎症反应并修复血管内皮损伤,促进肺循环功能恢复,其机制可能与灯盏花素注射液抑制TLR4/NF-κB通路有关。

Abstract

Objective To explore the effects of breviscapine Injection on the Toll-like receptor 4/nuclear factor-κB (TLR4/NF-κB) pathway and pulmonary circulation function in patients with acute pulmonary embolism (APE). Methods 105 APE patients were randomly divided into the conventional group (52 cases) and the experimental group (53 cases). The patients in conventional group received conventional treatment; the patients in the experimental group received conventional treatment and breviscapine injection. The TLR4/NF-κB signaling pathway proteins, inflammation-related factors, endothelial function-related factors, and pulmonary circulation functions of patients in the two groups were compared after treatment. Results After treatment, the TLR4 and NF-κB protein levels, as well as the inflammation-related factors monocyte chemoattractant protein-1 (MCP-1), macrophage inflammatory protein -1α (MIP-1α), interleukin-18 (IL-18), interleukin-33 (IL-33); endothelial function-related factors such as endothelial cell-specific molecule-1 (ESM-1), vascular cell adhesion molecule-1 (sVCAM-1), soluble thrombomodulin (sTM), asymmetric dimethylarginine (ADMA), pulmonary circulation function-related indicators systolic pulmonary artery pressure (sPAP), diastolic pulmonary artery pressure (dPAP), pulmonary vascular resistance (PVR), and ventilation/perfusion ratio (V/Q) in the experimental group were significantly lower than those in the conventional group (P＜0.05). The TLR4 and NF-κB protein levels of patients in the experimental group after treatment were positively correlated with each inflammation-related factor, endothelial function-related factor, and pulmonary circulation function-related indicator (P＜0.05). Conclusion The combination of breviscapine Injection and conventional treatment can alleviate APE inflammatory response, repair vascular endothelial damage, and promote the recovery of pulmonary circulatory function. The mechanisms may be related to inhibition of TLR4/NF-κB pathway by breviscapine Injection.

关键词

急性肺栓塞 / 灯盏花素注射液 / Toll样受体4/核转录因子-κB信号通路 / 炎症反应 / 肺循环功能

Key words

acute pulmonary embolism / breviscapine injection / toll-like receptor 4/nuclear factor-κB pathway / inflammatory response / pulmonary circulation function

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基金资助

2023年度南阳市基础与前沿技术研究专项立项（编号23JCQY1008）