外周血CD4^+CD28^+T淋巴细胞数量与阿托伐他汀对急性冠脉综合征患者干预的相关性

Influence of atorvastatin on peripheral CD4^+CD28^+T lymphocyte subpopulations in patients with acute coronary syndrome

目的:急性冠脉综合征患者T淋巴细胞活化增殖以及细胞因子分泌增加。实验拟进一步验证阿托伐他汀干预急性冠脉综合征患者炎症细胞因子和CD4+CD28+T淋巴细胞的变化。方法:选择2006-03/2006-07在南方医科大学附属珠江医院心内科住院患者30例。患者对治疗均知情同意,并经医院伦理委员会批准。急性冠脉综合征组20例(急性心肌梗死10例,不稳定心绞痛10例),稳定性心绞痛组10例作为对照。所有患者在随访的6个月中,除按照入院前冠心病治疗常规服用阿司匹林、玻立维、硝酸酯类等药物外,加用阿托伐他汀20mg,1次/d,持续服用到随访日期。采用ELISA检测各组患者治疗前后外周血清以及培养的外周血单个核细胞上清中肿瘤坏死因子α和干扰素-γ的水平,采用流式细胞仪检测患者治疗前后CD4+CD28+T淋巴细胞的数量。结果:30例患者均进入结果分析。阿托伐他汀治疗前后对比,急性冠脉综合征组外周血清以及培养的单个核细胞上清中肿瘤坏死因子-α和干扰素-γ的水平均明显下降(P均<0.001),而稳定性心绞痛组无明显变化(P>0.05),急性冠脉综合征组外周血CD4+CD28+T淋巴细胞数量明显减少(P<0.001),稳定性心绞痛组无明显变化。结论:急性冠脉综合征患者促炎症细胞因子以及外周血CD4+CD28+T淋巴细胞的数量接受阿托伐他汀干预可下调。

AIM： Patients with acute coronary syndrome （ACS） have an increased frequency of T lymphocytes cytokine secretion. This study was intended to verify the changes of inflammatory cytokine and CD4^＋CD28^＋T lymphocytes in patients with ACS treated with atorvastatin. METHODS： Totally 30 patients were enrolled at Department of Cardiology, Zhujiang Hospital Affiliated to Southern Medical University from March 2006 to July 2006. All patients singed the informed consent and approved by Hospital Ethics Committee. Twenty patients （10 cases of acute myocardial infarction, 10 cases of unstable angina pectoris） were in the ACS group and 10 patients in the stable angina pectods group as control. In the 6-month follow-up, all patients were treated with atorvastatin 20 mg once a day besides routed ACS treatment drugs such as aspirin, clopidogrel, nitrate and so on. Tumor necrosis factor （TNF）-α and interferon （IFN）-γ levels in serum and the peripheral blood T cells （PBTC） culture solution supernatant were measure again by ELISA and The quantity of CD4^＋CD28^＋T lymphocytes was detected by Flow Cytometry so as to make an observation on the changes of all patients. RESULTS： Totally 30 patients were involved in the result analysis. After treated with atorvastatin, the levels of TNF-α and IFN-γ in serum and in PBTC culture solution supernatant in the ACS group were significantly decreased （P 〈 0.001）, and no significant change was found in the stable angina pectoris group （P 〉 0.05）. The frequency of CD4^＋CD28^＋T lymphocytes in the ACS group was greatly reduced （P 〈 0.001）, and no significant change was found in the stable angina pectoris group. CONCLUSION： CD4^＋CD28^＋T lymphocytes frequency in patients with ACS treated with atorvastatin is reduced.