Th细胞分化特异性转录因子在低体质量先天性心脏病患儿肺血流异常发病机制中的作用  

The role of Th cell differentiation-specific transcription factors in the pathogenesis of abnormal pulmonary blood flow in children with low body mass congenital heart disease

作　　者：金立臣[1] 温林林[1] 韩喆[1] 张雪杰[1] 姚俊平[1] 宋海龙[1] 陶曙光[1] Jin Lichen;Wen Linlin;Han Zhe;Zhang Xuejie;Yao Junping;Song Hailong;Tao Shuguang(Department of Cardiology,Hebei Children's Hospital,Shijiazhuang 050031,China)

机构地区：[1]河北省儿童医院心脏外科,石家庄050031

出　　处：《疑难病杂志》2021年第4期344-347,352,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：河北省医学科学研究重点课题计划项目(20160414)。

摘　　要：目的观察Th细胞分化特异性转录因子在低体质量先天性心脏病(CHD)患儿肺血流异常发病机制中的作用。方法回顾分析2016年4月—2018年10月河北省儿童医院心脏外科收治的低体质量先天性心脏病患儿100例的临床资料,根据患儿肺充血情况,分为肺充血组(n=62)和肺缺血组(n=38),另取同期在医院治疗的其他疾病低体质量患儿50例作为对照组。比较各组患儿外周血淋巴细胞转录因子T-bet和GATA-3 mRNA表达,血浆IL-4和IFN-γ水平及外周血淋巴细胞亚群Th1/Th2细胞百分率的变化,通过Pearson法分析T-bet、GATA-3 mRNA表达量与Th1/Th2、血浆IL-4、IFN-γ水平的相关性。结果与对照组比较,肺充血组和肺缺血组患儿T-bet、GATA-3 mRNA表达,血浆IFN-γ、Th1细胞百分率、Th1/Th2水平均明显降低,血浆IL-4、Th2细胞百分率水平明显升高,且肺充血组患儿上述指标变化较肺缺血组更为显著(F/P=6.547/<0.001,9.254/<0.001,2.196/<0.001,65.254/<0.001,39.875/<0.001,3.026/<0.001,26.598/<0.001)。CHD患儿T-bet mRNA表达与血浆IFN-γ水平、Th1百分率呈正相关,与血浆IL-4水平、Th2百分率呈负相关(r/P=0.513/0.005,0.685/0.027,-0.764/0.000,-0.985/0.002),GATA-3 mRNA表达与血浆IL-4水平、Th2百分率呈正相关,与血浆IFN-γ水平、Th1百分率呈负相关(r/P=0.784/0.015,0.793/0.011,-0.525/0.032,-0.652/0.025)。结论 GATA-3和T-bet表达的平衡失调对Th1/Th2细胞的平衡偏移具有重要的调控作用,从而影响血浆IFN-γ、IL-4水平,在CHD的发病机制中起着重要作用。Objective To observe the role of Th cell differentiation-specific transcription factors in the pathogenesis of abnormal pulmonary blood flow in children with low-weight congenital heart disease(CHD).Methods A retrospective analysis of the clinical data of 100 children with low-weight congenital heart disease admitted to the Department of Cardiac Surgery of Hebei Children’s Hospital from April 2016 to October 2018.According to the children’s pulmonary congestion,they were divided into pulmonary congestion groups(n=62)and lung ischemia group(n=38).In addition,50 cases of low-weight children with other diseases treated in the hospital during the same period were taken as the control group.The expressions of T-bet and GATA-3 mRNA in peripheral blood lymphocytes,plasma IL-4 and IFN-γlevels,and the percentage of Th1/Th2 cells in peripheral blood lymphocyte subsets were compared in each group.T-bet and GATA-3 were analyzed by Pearson method Correlation between mRNA expression and Th1/Th2,plasma IL-4,IFN-γlevels.Results Compared with the control group,the expression of T-bet and GATA-3 mRNA,the percentage of plasma IFN-γ,Th1 cells,and Th1/Th2 levels of children in the pulmonary congestion group and lung ischemia group were significantly reduced,and the plasma IL-4 and Th2 cell percentage levels were significantly increased,And the changes in the above indicators of children in the pulmonary congestion group were more significant than those in the pulmonary ischemia group(F/P=6.547/<0.001,9.254/<0.001,2.196/<0.001,65.254/<0.001,39.875/<0.001,3.026/<0.001,26.598/<0.001).T-bet mRNA expression in children with CHD is positively correlated with plasma IFN-γlevel and Th1 percentage,and negatively correlated with plasma IL-4 level and Th2 percentage(r/P=0.513/0.005,0.685/0.027,-0.764/0.000,-0.985/0.002).GATA-3 mRNA expression is positively correlated with plasma IL-4 level and Th2 percentage,and negatively correlated with plasma IFN-γlevel and Th1 percentage(r/P=0.784/0.015,0.793/0.011,-0.525/0.032,-0.652/0.025).Conclu

关 键 词：先天性心脏病 Th细胞分化特异性转录因子 低体质量 发病机制 

分 类 号：R541.1[医药卫生—心血管疾病]