急性非ST抬高心肌梗死患者外周血CD4^(+)CD25^(+)Foxp3^(+)Treg和IL-27变化的临床意义  

The clinical significance of the changes of peripheral blood CD4^(+)CD25^(+)Foxp3^(+)and IL-27 in patients with acute non-ST elevation myocardial infarction

作　　者：王捷 蔡杰[3,2] 文明祥 廖晓星[2] 胡春林[2] 李玉杰[2] WANG Jie;CAI Jie;WEN Mingxiang;LIAO Xiaoxing;HU Chunlin;LI Yujie(Department of Intensive care medicine,the First Affiliated Hospital of Gannan Medical University;Emergency Department of the First Affiliated Hospital of Sun Yat-sen University;Department of Intensive care medicine,Union Medical College Shenzhen Hospital,Huazhong University of Science and Technology;Intensive care medicine Department of Guizhou Provincial People's Hospital)

机构地区：[1]赣南医学院第一附属医院重症医学科,赣州341001 [2]中山大学附属第一医院急诊科,广州510080 [3]华中科技大学协和深圳医院重症医学科,深圳518000 [4]贵州省人民医院重症医学科,贵阳550002

出　　处：《江西医药》2023年第6期657-660,666,共5页Jiangxi Medical Journal

基　　金：深圳市科技计划项目,编号JCYJ20160608142215491;广东省基础与应用基础研究基金项目,编号2020A1515010120。

摘　　要：目的观察急性非ST抬高心肌梗死患者(Non-STMI)治疗过程中外周血CD4^(+)CD25^(+)T/CD4^(+)T、CD4^(+)CD25highFoxp3^(+)Treg/CD4^(+)CD25high T比例及细胞因子TGF-β1、IL-10、INF-γ、IL-27的浓度变化,阐明Non-STMI患者是否存在调节性T细胞比例及功能异常。方法选取2012年8月至2016年4月入住中山大学附属第一医院急诊病房和CCU的Non-STMI40名,不稳定性心绞痛(UA)患者19名和同龄健康志愿者20名作为对照组(HC)。患者诊断明确后次日清晨和经规范治疗后5~7天,留取空腹外周血标本。流式细胞术检测CD4^(+)CD25^(+)T/CD4^(+)T、CD4^(+)CD25high Foxp3^(+)Treg/CD4^(+)CD25high T细胞。ELISA法检测细胞因子TGF-β1、IL-10、INF-γ和IL-27浓度。结果UA、Non-STMI组CD4^(+)CD25highFoxp3^(+)Treg/CD4^(+)CD25highT比例较HC组减低(P<0.01);Non-STMI明显低于UA组(P<0.05),而治疗后Non-STMI组Foxp3^(+)Treg细胞比例显著升高(P<0.05)。入院时Non-STMI和UA组TGF-β1、IL-10浓度较HC组明显降低(P<0.05),而INF-γ和IL-27浓度明显升高(P<0.05)。治疗后Non-STMI组IL-27迅速下降,而UA组变化不明显。治疗前IL-27浓度与CD4^(+)CD25highFoxp3^(+)Treg/CD4^(+)CD25highT呈线性负相关、与INF-γ浓度呈线性正相关。治疗后只有IL-27和CD4^(+)CD25high Foxp3^(+)Treg/CD4^(+)CD25highT呈线性负相关。结论Non-STMI患者CD4^(+)CD25highFoxp3^(+)Treg比例及功能异常,细胞因子IL-27有助于判断患者的临床疗效。Objective To observe the changes of peripheral blood CD4^(+)CD25^(+)T/CD4^(+)T,CD4^(+)CD25highFoxp3^(+)Treg/CD4^(+)CD25high T ratio and concentration of cytokines TGF-β1,IL-10,INF-γand IL-27 during the treatment of patients with acute non-ST elevation myocardial infarction(Non-STMI),to clarify whether there are abnormalities in the proportion and function of regulatory T cells in Non-STMIpatients.Methods 40 Non-STMIpatients who were admitted to the emergency ward and CCU of the First Affiliated Hospital of Sun Yat-sen University from August 2012 to April 2016,19 patients with unstable angina(UA)and 20 healthy volunteers of the same age were selected as controls Group(HC).The patient’s fasting peripheral blood samples were collected at the next morning after the diagnosis was confirmed and 5-7 days after standard treatment.Flow cytometry was used to detect CD4^(+)CD25^(+)T/CD4^(+)T,CD4^(+)CD25high Foxp3^(+)Treg/CD4^(+)CD25high T cells.ELISA method was used to detect the concentration of cytokines TGF-β1,IL-10,INF-γand IL-27.Results The ratio of CD4^(+)CD25highFoxp3^(+)Treg/CD4^(+)CD25highT in the UA and Non-STMIgroups was lower than that in the HC group(P<0.01),and Non-STMI was significantly lower than that in the UA group(P<0.05).The proportion of Foxp3^(+)Treg cells in the Non-STMI group increased significantly(P<0.05)after treatment.At admission,the concentrations of TGF-β1 and IL-10 in the Non-STMI and UA groups were significantly lower than those in the HC group(P<0.05),while the concentrations of INF-γand IL-27 were significantly increased(P<0.05).After treatment,IL-27 decreased rapidly in the Non-STMI group,while the UA group did not change significantly.Before treatment,IL-27 concentration was linearly negatively correlated with CD4^(+)CD25highFoxp3^(+)Treg/CD4^(+)CD25highT,and linearly positively correlated with INF-γconcentration.After treatment,only IL-27 and CD4^(+)CD25high Foxp3^(+)Treg/CD4^(+)CD25highT showed a linear negative correlation.Conclusion The ratio and function of CD4^(+)CD25highF

关 键 词：非ST抬高心肌梗死 CD4^(+)CD25^(+)Foxp3^(+)调节性T细胞 细胞因子 

分 类 号：R542.22[医药卫生—心血管疾病]