急性心肌梗死患者Th1细胞功能亢进及其意义  

Significance of upregulation of Thelper type 1 functions in patients with acute myocardial infarction

作　　者：程翔[1] 廖玉华[1] 李彬[1] 葛洪霞[1] 袁璟[1] 王敏[1] 刘英[1] 郭张强[1] 张玲[1] 

机构地区：[1]华中科技大学同济医学院心血管病研究所协和医院心内科,心血管免疫实验室,武汉430022

出　　处：《中华心血管病杂志》2004年第9期805-807,共3页Chinese Journal of Cardiology

基　　金：国家自然科学基金资助 (3 0 3 70 5 74)

摘　　要：目的　探讨急性心肌梗死 (acutemyocardialinfarction ,AMI)患者外周血辅助性T淋巴(Th)细胞亚群平衡偏移及意义。方法　采用流式细胞分析法 ,对 33例AMI、2 2例不稳定性心绞痛(UA)、2 0例稳定性心绞痛 (SA)和 2 1例胸痛综合征 (CPS)患者的外周血CD4 + 细胞胞内细胞因子干扰素γ(interferon gamma ,IFN γ)和白介素 4 (interleukin 4 ,IL 4 )进行动态监测。 结果　AMI组和UA组患者发病 2 4h内Th1型细胞因子IFN γ的表达增高 (2 2 4 %和 2 0 6 %) ,明显高于SA组(1 1 3%)和CPS组 (1 0 7%) ,而SA组和CPS组间差异无显著性 ;各组间Th2型细胞因子IL 4水平差异无显著性。UA组IFN γ高表达持续时间较短 ,发病 1周后恢复 (1 1 7%) ;AMI组IFN γ高表达持续时间较长 ,发病后 1周 (1 7 1 %)甚至 1个月 (1 5 1 %)仍高于CPS组。结论　AMI患者存在T细胞亚群平衡偏移 ,主要表现为Th1细胞功能亢进 ,可能是其发病机制之一 ;AMI患者T细胞亚群平衡偏移可能参与了AMI后自身免疫因素引起的心肌损伤和心室重塑过程。Objective To find out the significance of the imbalance of Th1/Th2 in patients with acute myocardial infarction. Methods Peripheral blood mononuclear cells were collected from 33 patients with acute myocardial infarction (AMI), 22 patients with unstable angina (UA), 20 patients with stable angina (SA) and 21 patients with chest pain syndrome (CPS). Cytokineproducing CD4 + T cells were quantified by 3color flow cytometry after stimulated with phorbol myristate acetate (PMA) and ionomycin. Results The frequencies of IFNγproducing T cells were found to be significantly higher in patients with AMI (22.4%) and UA (20.6%) within 24 hours after the onset of symptom than that of SA (11.3%) and CPS (10.7%). There was no significant difference on the frequencies of IL4producing peripheral T cells between each group. The high ratio of IFNγproducing T cells lasted short in patients with UA and recovered 1 week (11.7%)after the onset. In AMI patients, the high ratio of IFNγproducing T cells could be examined even 1 week (17.1%) and 1 month (15.1%) after the onset. Conclusion The Th1/Th2 functional imbalance exists in patients with AMI. The upregulation of Th1 cellfunctions may be one of the mechanisms of the onset of AMI. Th1/Th2 functional imbalance in AMI patients may participate in the immunemediated myocardial injury and ventricular remodeling after AMI.

关 键 词：患者 AMI IFN—γ TH1细胞 UA 亢进 平衡偏移 高表达 显著性 恢复 

分 类 号：R542.22[医药卫生—心血管疾病] R541.4[医药卫生—内科学]