心肌梗死后心功能不全患者辅助性T细胞功能失衡及意义  

The significance of Th1/Th2 function imbalance in patients with post-infarction cardiac insufficiency

作　　者：程翔[1] 廖玉华[1] 李彬[1] 张金盈[1] 葛洪霞[1] 袁璟[1] 王敏[1] 刘英[1] 郭张强[1] 陈静[1] 张锦[1] 陈鹏[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》2005年第6期526-528,共3页Chinese Journal of Cardiology

基　　金：国家自然科学基金资助(30370574)

摘　　要：目的探讨心肌梗死(MI)后心功能不全患者外周血辅助性T淋巴(Th)细胞功能失衡及意义。方法43例MI患者发病后1个月时,按照纽约心脏病协会(NYHA)心功能分级分为两组:MI1组(Ⅰ、Ⅱ级)和MI2组(Ⅲ、Ⅳ级),对两组患者进行心脏超声检测心功能指标。采用流式细胞分析法,检测两组患者外周血CD4+细胞胞内细胞因子干扰素γ(IFN-γ)和白介素4(IL-4)的表达。同时分离外周血单个核细胞(PBMC),经植物血凝素(PHA)刺激培养后,应用酶联免疫吸附方法(ELISA)检测培养液上清中IFN-γ和IL-4水平。结果MI2组患者IFN-γ染色阳性的细胞占CD4+T细胞的比率(16·9%)明显高于MI1组(13·3%),IL-4染色阳性细胞比率在两组间差异未见统计学意义。ELISA检测显示MI2组培养液上清中IFN-γ水平及IFN-γ/IL-4比值明显高于MI1组,而两组间IL-4水平差异无统计学意义。结论MI后患者Th细胞功能与心功能有一定关系,心功能差的患者Th1细胞功能明显亢进。Th细胞功能失衡可能参与了MI后的心室重构过程。Objective To study the significance of Th1/Th2 function imbalance in patients with post-infarction cardiac insufficiency.Methods Forty-three MI (myocardial infarction) patients were divided into 2 groups one month after the onset according to the New York Heart Association (NYHA) classification system: group MI 1 (Ⅰ、Ⅱ) 25 patients and group MI 2 (Ⅲ、Ⅳ) 18 patients. At the same time, the heart function was evaluated by two-dimensional echocardiography. Peripheral blood mononuclear cells (PBMCs) were collected from these patients. Cytokine-producing CD4+ T cells were quantified by 3-color flow cytometry after being stimulated with phorbol myristate acetate (PMA) and ionomycin. After being stimulated with PHA, the levels of IFN-γ and IL-4 in culture supernarants were measured by ELISA.Results The frequencies of IFN-γ-producing T cells were found to be significantly higher in group MI 2 (16.8%) than that in group MI1 (13.1%). There was no significant difference on the frequencies of IL-4-producing peripheral T cells between the two groups. The IFN-γ level and the ratios of IFN-γ/IL-4 in group MI 2 were significantly higher than those in group MI 1, while there was no significant difference in IL-4 levels between the two groups.Conclusions The Th-cell function was associated with heart function in post MI patients. The up-regulation of Th1 cell function was consistent with poor heart function, suggesting that Th1/Th2 cell function imbalance may participate in ventricular remodelling after MI.

关 键 词：心肌梗死 心功能不全 辅助性T细胞 细胞功能 心室重构 

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