高血压并冠状动脉粥样硬化与辅助性T淋巴细胞亚群

Helper T Cells and Coronary Atherosclerosis in Hypertensive Patients

背景辅助性T细胞亚群中Th1细胞分泌干扰素(IFN-γ),Th2细胞分泌白介素4(IL-4),有报道认为动脉粥样硬化病人Th1/Th2平衡紊乱。目的探讨血管紧张素Ⅱ(AngⅡ),IFN-γ和IL-4与高血压患者冠状动脉粥样硬化的关系,研究他们的Th1/Th2功能平衡有无紊乱。方法临床及冠状动脉造影确诊的高血压合并冠状动脉粥样硬化患者30例为病例组,冠状动脉造影排除冠状动脉粥样硬化的高血压患者22例为对照组。采用放射免疫法检测血浆AngⅡ水平,ELISA法检测血浆中IFN-γ和IL-4水平。结果1)病例组AngⅡ[(64.7±30.1)vs对照组(36.1±12.0)ng/L,P<0.05]、IFN-γ[(10.3±5.4)vs(4.2±1.5)ng/L,P<0.01]水平增高;2)病例组IL-4水平无明显变化[(15.7±7.0)vs对照组(13.5±7.0)ng/L,P>0.05];3)病例组IFN-γ与IL-4比值较对照组增大(0.72±0.34vs0.35±0.17,P<0.01);4)AngⅡ水平与IFN-γ水平呈正相关(r=0.51,P<0.01),而与IL-4水平无相关性(r=0.11,P>0.05)。结论高血压患者的高AngⅡ水平使辅助性T淋巴细胞亚群Th1细胞活性升高,导致辅助性T淋巴细胞亚群Th1/Th2的功能失衡与冠状动脉粥样硬化发生、发展有关。

Objective To explore the relationship between angiotensin Ⅱ （Ang Ⅱ ）, the levels of IFN-γ, IL-4 and coronary atherosclerosis in patients with hypertension. Methods Based on clinical diagnosis and coronary angiography, fifty two hypertensive patients were categorized into： patients with coronary atherosclerosis （CAD group, n= 30） and the control group without coronary atherosclerosis （control, n= 22）. The levels of plasma Ang Ⅱ were measured using radioimmunoassay and IFN-γ and IL-4 by ELISA. Results Ang Ⅱ （ 64.7 ±30. 1 vs control 36. 1±12.0 ng/L, P〈0. 05） and IFN-γ（10. 3±5.4 vs 4.2±1.5 ng/L, P〈0.01） levels were markedly increased in CAD group compared with the control, while the levels of IL-4 was of little difference （15.7 ±7.0 vs control 3.5±7.0 ng/L, P〉0.05）. The ratios of IFN-γ/IL-4 in patients with coronary artery sclerosis were higher than those in controls（0.66 vs 0.31, P〈0. 011. Ang Ⅱ were positively correlated with the levels of IFN-γ（r= 0.51, P〈0.01 ） and no correlation was found between Ang Ⅱ and IL-4 （ r = 0.11, P〉0.05 ）. Conclusion High levels of Ang Ⅱ may associate with inbalance between Th1 switch and the imbalance of Th1/Th2 subsets, which may involve in coronary atherosclerosis progression in hypertensive patients.