急性冠脉综合征患者外周免疫细胞的变化及临床意义  

The change and chinical significance of peripheral immunocytes of patients with acute coronary syndrome

作　　者：李庆[1] 陈坷[2] 徐修才[1] 胡超杰[1] 张翠萍[1] 邬志伟[1] 

机构地区：[1]安徽医科大学附属省立医院中心实验室,安徽合肥230001 [2]安徽医科大学附属省立医院心血管内科,安徽合肥230001

出　　处：《中国现代医学杂志》2011年第21期2611-2615,2619,共6页China Journal of Modern Medicine

基　　金：安徽省青年自然科学基金(No.11040606Q08);安徽高校省级自然科学研究重点资助项目(No.KJ2011A166);安徽医科大学校科研基金(No.2010xkj083)

摘　　要：目的探讨急性冠脉综合征(AC S)患者外周血中免疫细胞的表达变化及其临床意义。方法采用流式细胞术检测24例急性心肌梗死(AM I)患者、22例不稳定性心绞痛(U A)患者、26例稳定性心绞痛(SA)患者和20例冠状动脉造影正常(N C A)的对照组的外周血T淋巴细胞亚群、C D 4+C D 25+调节性T细胞(Treg细胞)、N K细胞和N KT细胞的表达水平。结果与对照组和SA组比较,AM I组和U A组患者外周血C D 4+T细胞的表达明显升高(P<0.05),C D 8+T细胞、C D 4+C D 25+调节性T细胞、N K细胞和N KT细胞水平显著降低(P<0.05);AM I患者C D 4+T细胞明显高于U A患者,而C D 8+T细胞和Treg细胞则显著低于U A患者(均P<0.05);SA组患者除C D 4+C D 25+C D 127low Treg细胞表达率显著低于N C A组外,其余各指标与N C A组均无明显差异(均P>0.05)。结论 AC S患者外周T细胞亚群、调节性T细胞、N K细胞和N KT细胞的异常表达反映其免疫调节受损,免疫细胞表达的变化与AC S的发生发展密切相关,免疫细胞可能成为AC S发病机制研究和干预治疗的重要靶点。【Objective】 To investigate expression change and clinical significance of peripheral immunocytes in patients with acute coronary syndrome.【Methods】 24 patients with acute myocardial infarction,22 patients with unstable angina,26 patients with stable angina,and 20 controls with normal coronary arteries（NCA） were studied.The expression of peripheral T cell subsets,CD4^＋CD25^＋ regulatory T cells（Treg）,NK cells and NKT cells were detected by flow cytometry.【Results】 Compared to NCA and SA group,the levels of CD4^＋ T cells increased significantly in AMI group and UA group,while the levels of CD8^＋ T cells,Treg cells,NK cells and NKT cells decreased significantly（P〈0.05）.The levels of CD4^＋ T cells in AMI group were significantly higher than those in UA group,while the Levels of CD8^＋ T cells and CD4^＋CD25^＋CD127low Treg cells in AMI group were markedly lower than those in UA group（all P〈0.05）.The expressions of CD4^＋CD25^＋CD127low Treg in SA patients were apparently lower than NCA group（P〈0.05）,however,there were no significant differences in other indicators between SA and NCA group（all P〈0.05）.【Conclusions】 The abnormal expression of T cell subsets,Treg cells,NK cells and NKT cells reflected damaged immune regulation in ACS patients,and change of immunocyte are closely related to the occurrence and development of ACS.Immunocytes might become important targets of pathogenesis research and intervention treatment for ACS.

关 键 词：急性冠脉综合征 免疫细胞 流式细胞术 

分 类 号：R543.3[医药卫生—心血管疾病]