不同心功能患者T淋巴细胞亚群的变化

Changes of T lymphocyte subsets in patients with different cardiac functions

目的研究不同心功能分级患者外周血T淋巴细胞亚群的变化。方法健康体检者39例为对照组,器质性心脏病患者84例,根据心功能分级标准(NYHA),心功能Ⅰ级组33例,Ⅱ级组20例、Ⅲ级组16例、Ⅳ级组15例。采用流式细胞仪测定外周血T淋巴细胞亚群CD3、CD4、CD8,计算CD4/CD8比值,超声心动图测定左心室射血分数(LVEF)。结果T淋巴细胞亚群CD3水平在对照组和心功能Ⅰ、Ⅱ、Ⅲ、Ⅳ级组之间差异无显著性;CD4水平从心功能Ⅰ级至Ⅳ级组逐渐降低,对照组及心功能Ⅰ级组与心功能Ⅲ级组、Ⅳ级组比较,差异均有显著性(P<0.01),心功能Ⅱ级组与Ⅳ级组比较差异也有显著性(P<0.05);CD8水平在心功能Ⅳ级组明显升高;CD4/CD8与CD4变化相一致,随心功能减退而降低。结论心力衰竭患者存在细胞免疫功能异常,随心功能减退辅助性T淋巴细胞数量减少,提示调节细胞免疫治疗可能会使心力衰竭患者获益。

Objective To Study the changes of T lymphocyte subsets in patients with different cardiac dysfunctions.Methods Thirty-nine normal controls and 84 patients with heart diseases were analyzed. According to NYHA standard, 84 patients were divided into 33 cases of grade 1,20 cases of grade 2,16 cases of grade 3 and 15 cases of grade 4. Flow cytometry was applied for assessing proportions of CD3 T cells, CD4 T ceils and CDs T ceils and CD4/CD8 ratio. Echocardiography was used to measure the ejection fraction of left ventricle （LVEF） .Results The levels of CD3 T cells were not significantly different between nounal controls and different cardiac dysfunction groups. The levels of CD4 T cells gradually decreased from cardiac dysfunction of grade-1 group to grade-4 group, and there were significant differences between normal control group, cardiac dysfunction of grade-1 group, grade-3 group and grade-4 group（ P 〈 0. 01 ）. The change of CD4/CD8 ratio was same as that of CD4 T cells and decreased with increasing cardiac dysfunction. Conclusions There is abnormal ceil immune function and the number of helper T cells is reduced in patients with heart failure. The results show that the treatment with regulating cell immune function may be beneficial to patients with heart failure.