慢性炎症和T淋巴细胞活性与心绞痛的相关研究  

The Investigation on Relationship of Chronic Inflammation and T Lymphocyte Cell Activity with Angina Pectoris

作　　者：陈冰雪[1] 刘莉[1] 陈盛鹏[1] 窦静[1] 

机构地区：[1]白求恩军医学院内科教研室,石家庄050081

出　　处：《白求恩军医学院学报》2007年第6期331-332,共2页Journal of Bethune Military Medical College

摘　　要：目的测定冠心病心绞痛患者外周静脉血中白细胞介素-18(IL-18)、C-反应蛋白(CRP)浓度及外周血辅助性T淋巴细胞(Th)功能的改变,观察心绞痛与非感染性炎症及细胞免疫功能之间的关系。方法应用酶联免疫吸附法(ELISA)测定外周血清IL-18浓度,速率散射比浊法测量CRP浓度;采用流式细胞分析法检测外周血CD4+细胞内干扰素γ(IFNγ-)和白细胞介素4(IL-4)的表达。同时分离外周血单个核细胞,经植物血凝素刺激培养后,应用ELISA检测培养上清液中IFNγ-和IL-4水平以测定辅助性T淋巴细胞的功能改变。结果与对照组比较,心绞痛组患者炎性因子(IL-18和CRP浓度)和辅助性T淋巴细胞因子(IFNγ-)水平以及IFNγ-/IL-4比值明显高于对照组;IFNγ-染色阳性的细胞占CD4+T细胞的比率为15.34%,明显高于对照组的12.09%。而两组间IL-4水平及IL-4染色阳性细胞比率在两组间未见显著统计学差异。在心绞痛分组中,不稳定型心绞痛(UAP)组的IL-18、CRP、IFNγ-水平以及IFNγ-/IL-4比值明显高于稳定型心绞痛(SAP)组。结论IL-18、CRP、IFNγ-浓度随冠状动脉病变的程度而升高,且与动脉粥样硬化斑块的稳定性有关。提示炎性因子和辅助性T淋巴细胞功能的失调可能参与了心绞痛患者冠脉粥样硬化斑块形成的过程。IL-18与CRP、IFNγ-浓度可能对冠心病心绞痛患者的诊断及预后有重要参考价值。Objective To measure the concentration of interleukinl8（IL-18）,C-reactive protein（CRP）and ceil-mediated immunity function in patients with coronary heart disease and angina pectoris and evaluate their clinical correlation. Methods IL-18 was measured with ELISA, and scram CRP with rate scatter nephelometry, cytokine-producing CD4^＋ T cells with 3-color flow cytometry. The levels of interferon-gamma （IFN-γ） and IL-4 in culture supematants were measured with ELISA. RegMts The concentrations of IL-18, CRP, IFN-γ and ratio of IFN-γ/IL-4 in patients with angina pectoris were much higher than those in control. The frequencies of IFN-γ-producing T cells were found to be significantly higher in angi- na pectoris group（ 15.34% ） than those in control（ 12.09% ）, while there was no significant difference on the frequencies of IL-4-producing peripheral T-lymphocytes between the two groups. In angina pectoris group, the concentrations of IL-18,CRP, IFN-γ and ratio of IFN-γ/IL-4 in unstable angina pectoris were much higher than those in stable angina pectoris. Conclusion The concentratious of IL-18, CRP, IFN-γ were increased with coronary arteriosclerosis and related to the stability of atherosclerotic plaques, suggesting that inflammation factor and imbalance of cell-mediated immunity function may participate in formation of atherosclerotic plaques. The concentrations of IL-18, CRP, IFN-γ perhaps had important values in diagnosing coronary artery diseases.

关 键 词：白细胞介素 C-反应蛋白 干扰素Γ T淋巴细胞 心绞痛 

分 类 号：R392.12[医药卫生—免疫学] R54[医药卫生—基础医学]