体外心脏震波对慢性心力衰竭患者CD4CD25调节性T细胞的影响  

Effect of extracorporeal cardiac shock wave therapy on CD4CD25 regulatory T cells in chronic heart failure patients

作　　者：凡孝琴[1] 章春艳[1] 邱春[1] 李梓香[1] 谢华强[1] 曹政[1] 杨勇[1] 

机构地区：[1]十堰市太和医院心内科湖北医药学院附属医院,442000

出　　处：《中华老年心脑血管病杂志》2016年第3期257-261,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：湖北省自然科学基金(2013CFB470)

摘　　要：目的探讨体外心脏震波(CSWT)治疗对冠心病慢性心力衰竭(CHF)患者CD4CD25调节性T细胞(CD4CD25regulatory T-cells,Tregs)的影响。方法选取诊断为冠心病CHF、LVEF<50%的患者68例,随机分为试验组34例(给予震波能量0.09mJ/mm2治疗,3个月1个疗程,共9次震波治疗)和对照组34例(治疗同试验组,但不予震波能量)。入选者在治疗前后行加拿大心绞痛及纽约心功能分级,并行核素显像评价存活/缺血心肌。流式细胞仪检测患者Tregs数目,细胞增殖试验检测Tregs功能。结果试验组治疗后的纽约心功能分级、加拿大心绞痛分级较治疗前均减低(P<0.05),左心室灌注总分和代谢总分降低(P<0.05),Tregs数目[(6.25±1.86)%vs(3.43±1.75)%]和Tregs功能较治疗前增加(P<0.05),上清液中转化生长因子β和白细胞介素10浓度升高,干扰素γ分泌下降(P<0.05);对照组治疗前后比较,上述指标无统计学差异(P>0.05)。结论 CSWT治疗可提高CHF患者Tregs数目及功能,调控CHF时的炎性反应,缓解心绞痛、改善心脏功能,提高生活质量及运动耐量。Objective To study the effect of extracorporeal cardiac shock wave therapy （CSWT） on CD4CD25 regulatory T cells （Tregs） in chronic heart failure （CHF） patients. Methods Sixtyeight CHF patients with their LVEF〈50% were randomly divided into CSWT group（n=34） and control group （n= 34）. The patients in CSWT group received 9 times of CSWT（0.09 mJ/mm2） in 3 months and those in control group did not received CSWT. Their Canadian Cardiovascular Society （CCS） angina and NYHA cardiac function were graded and their survival time/ischemic myocardium were assessed according to the nuclide imaging. The number of Tregs was detected by flow cytometry and the function of Tregs was assayed by mixed lymphocyte reaction. Results The NYHA cardiac function grading and the CCS angina grading were lower whereas the Seattle angina questionnaire scale score, 6-MWT, the number and function of Tregs were significantly higher in CSWT group after treatment than before treatment （P〈0.05）. The serum IL-10 and TGF-β levels were significantly higher whereas the serum IFN-γ level was significantly lower in CSWT group after treatment than before treatment （P〈 0. 05）. No significant difference was found in the above parameters between CSWT group and control group before treatment （P〉 0.05）. Conclusion CSWT can increase the number and function of Tregs,regulate inflammatory reaction, alleviate angina,improve cardiac function and quality of life in CHF patients.

关 键 词：心力衰竭 转化生长因子Β 白细胞介素10 干扰素Ⅱ型 T淋巴细胞 体外心脏震波 

分 类 号：R541.6[医药卫生—心血管疾病]