急性心肌梗塞病人血清sIL-2R水平、mIL-2R和T淋巴细胞亚群的变化

Changes of the sIL 2R,mIL 2R and T Lymphocyte Subpopulations in Acute Myocardial Infarction

目的探讨急性心肌梗塞发病中免疫指标的变化。方法应用单克隆与多克隆双抗体夹心法检测６６例急性心肌梗塞（ＡＭＩ）病人发病后第１周内血清可溶性白细胞介素－２受体（ｓＩＬ－２Ｒ）的变化，同时检测外周血淋巴细胞膜白细胞介素－２受体（ｍＩＬ－２Ｒ）表达及Ｔ淋巴细胞亚群的变化。结果ＡＭＩ病人血清ｓＩＬ－２Ｒ明显增高，ｍＩＬ－２Ｒ表达明显降低，与对照组比较差异有极显著性意义（Ｐ＜０．００１）。发病后第１ｄ至第７ｄ，ｓＩＬ－２Ｒ增高和ｍＩＬ－２Ｒ表达降低一直比较明显。ＡＭＩ病人ＣＤ４、ＣＤ８和ＣＤ４／ＣＤ８明显低于对照组（Ｐ＜０．００１），以第１ｄ降低最明显，以后逐渐升高，ＣＤ８于第７ｄ恢复正常。４ｄ内死亡者和伴有室性心律失常（ＶＡ）者上述指标变化更明显。结论血清ｓＩＬ－２Ｒ水平、ｍＩＬ－２Ｒ表达和Ｔ淋巴细胞亚群变化与ＡＭＩ病情和预后有密切关系。

Aim To investigate the changes of immunological indexes in acute myocardial infarction.\ Methods\ The levels of soluble interleukin 2 receptor(sIL 2R) was measured during the first week in patients with acute myocardial infarction(AMI).\ Meanwhile the expression of lymphocyte membrane interleukin 2 receptor(mIL 2R) and the frequencies of T lymphocyte subpopulation(CD 4,CD 8) were also evaluated.\ Results\ The levels of sIL 2R was significantly higher and the expression of mIL 2R was significantly lower in AMI patients than those in controls( P <0 001).\ Significantly higher levels of sIL 2R and lower expression of mIL 2R were showed a trend of increase and decrease from day 1 to 7.\ CD 4, CD 8 and CD 4/CD 8 ratio were significantly lower in AMI patients than those in controls( P <0 001). The changes were more obvious on the first day.\ These changes were more obvious in patients with ventricular arrhythemia(VA) and died before the fouth day than in patients without VA and survivals( P <0 001).\ Conclusions\ The sIL 2R levels.\ mIL 2R expression and T lymphocyte subpopulations might be closely related to the severity and prognosis of AMI.