循环滤泡辅助T细胞在急性冠状动脉综合征患者中的分布及其与Gensini评分的关系  

The distribution of circulating T follicular helper cells and its association with Gensini score in patients with acute coronary syndrome

作　　者：张丽莎 邓伏雪 褚超[2] 蒋伟[1] 张艳[1] ZHANG Lisha;DENG Fuxue;CHU Chao;JIANG Wei;ZHANG Yan(Department of Cardiology,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an,710004,China;Department of Cardiology,the First Affiliated Hospital of Xi'an Jiaotong University)

机构地区：[1]西安交通大学第二附属医院心血管病院,西安710004 [2]西安交通大学第一附属医院心血管内科

出　　处：《临床心血管病杂志》2024年第1期46-51,共6页Journal of Clinical Cardiology

基　　金：国家自然科学基金(No:81700368);陕西省自然科学基金(No:2021JM-291)。

摘　　要：目的:探究外周血循环滤泡辅助T细胞(circulating T follicular helper, cTfh)及其亚型在急性冠状动脉综合征(ACS)患者中的分布情况,及其与冠状动脉(冠脉)狭窄程度(Gensini评分)的关系。方法:采用酶联免疫吸附法检测ACS患者(ACS组,85例)及冠脉造影正常者(NCA组,43例)外周血白细胞介素21(interleukin-21,IL-21)水平,应用流式细胞术分析两组试验对象外周血cTfh水平及其亚型所占比例,同时进行相关性分析、回归分析探究其与冠心病传统危险因素及Gensini评分的关系。结果:与NCA组相比,ACS患者外周血IL-21及cTfh水平显著升高(IL-21:74.6 pg/mL vs 153.6 pg/mL,P<0.001;cTfh:1.40%vs 2.23%,P=0.016),且cTfh亚型比例失调(以Tfh17亚型升高为主:24.0%vs 27.2%,P=0.015)。冠心病传统危险因素中,仅低密度脂蛋白胆固醇水平与Tfh2亚型呈弱正相关性(r=0.213,P=0.016);高水平IL-21(OR=4.657,95%CI:2.053~10.563,P<0.001)、cTfh(OR=1.250,95%CI:1.063~1.470,P<0.007)及Tfh17(OR=1.063,95%CI:1.002~1.129,P<0.044)为ACS的危险因素,但均与Gensini评分无关联。结论:ACS患者外周血IL-21及cTfh水平升高,cTfh亚型失调。Tfh可能参与ACS的发生发展,但尚未发现其与冠脉狭窄程度的关系。Objective To investigate the distribution of circulating T follicular helper cells(cTfh)and its association with the Gensini score in patients with acute coronary syndrome(ACS).Methods The cTfh and its subsets from a total of 85 ACS patients(ACS group)and 43 patients with normal coronary arteries(NCA group)were investigated using flow cytometry.Plasma level of interleukin-21(IL-21)were examined and the Gensini score was calculated from coronary angiograms.The association of IL-21/cTfh with atherosclerosis risk factors or Gensini score was assessed by correlation analysis and regression analysis.Results The percentage of total cTfh cells and Tfh17 cells in cTfh cells were significantly increased in the ACS group compared with the NCA group(cTfh:1.40%vs 2.23%,P=0.016;Tfh17:24.0%vs 27.2%,P=0.015).In addition,IL-21 content in plasma increased in the ACS group(74.6 pg/mL vs 153.6 pg/mL,P<0.001).Only the percentage of Tfh2 in cTfh was related to low density lipoprotein cholesterol LDL-C level(r=0.213,P=0.016).Higher plasma IL-21 concentration(OR=4.657,95%CI:2.053-10.563,P<0.001),cTfh(OR=1.250,95%CI:1.063-1.470,P<0.007),and Tfh17(OR=1.063,95%CI:1.002-1.129,P<0.044)were risk factors of ACS,however,none of them were associated with the Gensini score.Conclusion Patients with ACS show a high expression of IL-21 and cTfh,as well as a dysregulation of cTfh subtypes.Tfh may be involved in the occurrence and development of ACS,but the relationship between cTfh and the degree of coronary artery stenosis has not been found yet.

关 键 词：急性冠状动脉综合征 循环滤泡辅助T细胞 白细胞介素21 GENSINI评分 冠状动脉狭窄 

分 类 号：R541.4[医药卫生—心血管疾病]