急性冠状动脉综合征患者Th17细胞检测及意义

Significance of the alteration of Th17 cells in patients with acute coronary syndrome

目的:探讨急性冠状动脉综合征患者外周血辅助性T细胞(Thelp,Th)17的水平及意义。方法:将85例患者分为4组:急性心肌梗死(AMI)组26例,不稳定型绞痛(UA)组17例,稳定型心绞痛(SA)组22例和胸痛综合征(CPS)组20例。采用流式细胞分析法,检测各组患者外周血Th17细胞占CD4+T细胞比例。应用酶联免疫吸附方法(ELISA)检测患者外周血血浆Th17相关细胞因子白细胞介素(IL)-17和IL-23的表达。结果:AMI组和UA组患者外周血Th17/CD4+T细胞比例分别为(2.3±1.3)%、(2.1±1.1)%,明显高于SA组(0.5±0.3)%和CPS组的(0.3±0.2)%(P<0.01)。AMI组和UA组患者IL-17和IL-23水平[IL-17:AMI组(72.3±50.2)ng/L、UA组(64.6±38.7)ng/L;IL-23:AMI组(615±254)ng/L、UA组(571±252)ng/L]亦明显高于SA组[IL-17:(24.2±15.3)ng/L,IL-23:(136±67)ng/L]和CPS组[IL-17:(20.8±13.3)ng/L,IL-23:(128±70)ng/L],P<0.05;而SA组和CPS组间差异无统计学意义(P>0.05)。患者血浆IL-17水平与血浆IL-23水平呈正相关(r=0.631,P<0.01)。结论:急性冠状动脉综合征患者外周血Th17细胞比例增加,IL-17、IL-23水平升高,Th17细胞可能参与动脉粥样斑块不稳定和急性冠状动脉综合征的发病。

Objective： To investigate the alteration and its significance of T help 17 cells （Tb17）, in patients with acute coronary syndrome. Method： 85 patients were divided into four groups： acute myocardial infarction （AMI, n=26）, unstable angina （UA, n=17）, stable angina （SA, n=22） and chest pain syndrome （CPS, n= 20）. The frequencies of Th17 in peripheral blood were detected by flow cytometric analysis. Th17-related plasma cytokine （including IL-17 and IL-23） concentrations were measured by enzyme-linked immunosorbent assay. Resuit：The frequencies of Th17 in peripheral blood were found to be significantly higher in patients with AMI and UA than those with SA and CPS （P〈0. 01）. Th17 related cytokine IL-17 and IL-23 markedly increased in patients with AMI （IL-17： [72.3±50.2] ng/L; IL-23： [615±2542ng/L） and UA （IL-17： [64. 6±38. 7] ng/L; IL-23： [571±252] ng/L） compared with patients with SA （IL-17.. [24.2±15.3]ng/L; IL-23： [138±67]ng/L） and CPS （IL-17： [20.8±13.3]ng/L; IL-23： [128±70]ng/L）. Plasma concentration of IL-17 was positively correlated with concentration of IL-23 in four groups （r=0. 631, P〈0.01）. Conclusion：The frequencies of Thl7 increased in patients with acute coronary syndrome which may suggest a potential role for Th17 in the progression and stability of the atheroma.