急性冠脉综合征患者不同部位血Th17细胞和IL-17对比分析  

Analysis of blood Th17 cell and IL-17 from different regions of body in patients with acute coronary syndrome

作　　者：陈玉林[1] 菅颖[1] 刘民杰[1] 张芳[1] 杨威风[1] 徐曌[1] 陈国藩[1] 

机构地区：[1]杭州师范大学附属医院心内科,杭州310015

出　　处：《中华急诊医学杂志》2016年第1期83-87,共5页Chinese Journal of Emergency Medicine

基　　金：浙江省自然科学基金（Y2100526）;浙江省科技厅科研项目（2009C33149）

摘　　要：目的比较急性冠状动脉综合征（acute coronary syndrome，ACS）患者周围血和冠状动脉罪犯血管病变处血辅助性T细胞17（helper T cells，Th17）占CD4^＋T细胞的比例以及IL-17水平，分析其临床意义。方法序贯入选2012年2月15日至2012年10月15Et杭州师范大学附属医院接受冠状动脉造影（CAG）的冠心病（coronary heart disease，CHD）及疑诊冠心病患者76例。分为ACS组、稳定性心绞痛（stable angina，SA）组和对照组。所有患者均在做完冠状动脉造影后即刻采集肘静脉血5mL。ACS患者同时采集罪犯血管病变处血5mL。采用流式细胞术检测不同部位血Th17的百分率。用ELISA法检测不同部位血血清白细胞介素（interleukin，IL）-17的质量浓度。结果ACS患者周围血Thl7细胞占CD4^＋T细胞的比例和冠状动脉罪犯血管病变处血Th17细胞占CD4^＋T细胞的比例分别是（3．18±0．29）％和（3．17±0．30）％，差异无统计学意义（P=0．919）。ACS组、SA组和对照组外周血Thl7细胞占CD4^＋T细胞的比例分别是（3．18±0．29）％、（1．32±0．31）％和（1．28±0．33）％，ACS组与另外两组相比差异均有统计学意义（P〈0．01），但SA组和对照组比较，差异无统计学意义。ACS外周血和冠状动脉罪犯血管病变处血血清IL-17质量浓度分别是（81．23±18．63）pg／mL和（82．37±20．51）ps／mL，差异无统计学意义（P=0．573）。ACS组外周血IL-17水平分别与SA组和对照组相比，差异均有统计学意义。但SA组和对照组比较差异无统计学意义。结论ACS患者周围血Th17细胞百分比以及IL-17水平与冠状动脉罪犯血管病变处相似，原因可能是多方面的。ACS患者外周血Th17细胞比例增加、IL-17水平升高，这可能参与动脉粥样硬化斑块不稳定的形成，这个过程导致ACS发病。Objective To investigate the differences and significance of blood levels of T helper 17 （Th17） cell and interleukin17 （IL-17） between peripheral and culprit vessels in patients with acute coronary syndrome. Methods A total of 76 patients recruited in 2012 were divided into three groups according to the coronary angiography and clinical manifestations： acute coronary syndrome, stable angina and control groups. The blood samples were taken from cubital vein and culprit coronary artery after coronary angiography. The percentage of Thl7s among CD4^＋ T ceils was detected by flow cytometric analysis and the IL-17 levels were measured by enzyme-linked immunosorbent assay. Results There was no significant difference in the percentages of Th17 cells between peripheral blood and culprit artery blood [ （3.18±0. 29）%vs. （3. 17 ± 0. 30） %, （ P = 0. 919） ] ; but the perecentages of Th17 in peripheral blood were found to be significantly higher in patients with acute coronary syndrome （ 3.18± 0. 29 ） % than those with stable angina （ 1.32 ± 0. 31 ） % and those without coronary heart disease （ 1.28 ± 0. 33 ） % , （P 〈 0. 01 ）. There was no significant difference in the.level of IL-17 between peripheral blood and culprit artery blood [ （ 81.23 ± 18.63 ） vs. （ 82. 37 ± 20. 51 ） pg/mL, P = 0. 573 ] ; but the level of IL-17 in peripheral blood was also significantly higher in patients with acute coronary syndrome than those with stable angina and those without coronary heart disease [ （81.23 ±18.63） vs. （25.96 ±14.58） pg/mLor （23.75 ±13.64） pg/mL, P〈0.01]. Condation There were no significant differences in percentage of Th17 cell among CD4^＋ T cells and levels of IL-17 in blood between peripheral and culprit vessels in patients with acute coronary syndrome. The percentage of Th17 among CD4^＋ T cells and the levels of IL-17 in blood increase in patients with acute coronary syndrome suggesting a potential role of Th17 and IL-17 in the development and instabi

关 键 词：急性冠状动脉综合征 动脉粥样硬化 TH17细胞 罪犯血管 IL-17 

分 类 号：R541.4[医药卫生—心血管疾病]