不同类型冠心病患者外周血树突状细胞分型及功能研究

Variation in Quantity,Percentage,and Functions of Peripheral Blood Dendritic Cells in Patients with Different Types of Coronary Artery Diseases

目的研究不同类型冠心病患者外周循环中树突状细胞(dendritic cells,DCs)数量和功能的变化,探讨DCs与冠脉粥样硬化斑块从稳定到易损的关系。方法将62例冠心病患者分为稳定型心绞痛组(SAP组,17例)、不稳定型心绞痛组(UAP组,15例)、急性冠脉综合征组(ACS组,15例)、急性心肌梗死组(AMI组,15例),冠状动脉造影阴性患者为对照组(CTL组,18例)。流式细胞4色分析法检测DCs及亚型的比例,流式细胞仪及酶联免疫吸附实验(ELISA)检查DCs功能。结果(1)与CTL组比较,SAP组外周血DCs血白细胞的比例和数量无显著变化;UAP组DCs比例和数量显著增高;AMI组DCs比例和数量均减少;ACS组DCs比例降低,数量无显著改变。(2)冠心病患者外周血单核细胞源性DCs功能测定:①培养第7天,UAP、ACS、AMI组DCs CD86表达高于CTL、SAP组,ACS、AMI组显著高于UAP组(P<0.01)。②培养第7天,在DCs数量为2×105/mL时,UAP、ACS、AMI组DCs刺激T细胞增殖的能力显著高于CTL、SAP组(P<0.01),ACS、AMI组显著高于UAP组(P<0.01),AMI组较ACS组有升高趋势。③混合淋巴细胞反应上清液中IL-12、IFN-α浓度比较,UAP、ACS、AMI组显著高于CTL、SAP组;ACS、AMI组显著高于UAP组(P<0.01);AMI组高于ACS组(P<0.05)。结论冠心病患者外周血DCs数量、比例及功能可一定程度反映冠心病患者冠脉斑块稳定性的变化。

Objective Variation in quantity, percentage, and functions of peripheral blood dendritic cells （DCs） in the patients with different types of coronary artery diseases （CAD） has been detected in this paper, so as to explore the relations between the DCs and the progression of coronary artery plaques. Methods A total of 62 CAD patients Of deferent types were divided into four groups：AMI group （n=15）,ACS group （n=15）,UAP group （n=15） and SAP group （n=17）. The control group （CTR group） was comprise of 18 patients whose result of coronary angiography were negative （n= 18）. The quantity and percentage of peripheral blood DCs and the subsets were measured by four color flow cytometry. The functions of DCs were measures by ELISA and flow cytometry. Results （1）Quantity and percentage.compared with CTR group,there was no notable difference in the percentage and quantity of DCs in the leukocyte population in SAP group, while they were significantly higher in UAP group,and lower in AMI group. The percentage of DCs lowered in ACS group with no obvious change in quantity compared with CTR group. （2） Functions：The functions of the DCs were detected after 7 day culture in vitro. CD86 expression level in UAP,ACS and AMI group was higher than that in CTR and SAP group,and it was significantly higher in ACS and AMI group than UAP group （P〈0.01）. The DCs＇ capability of stimulating T-cell proliferation in UAP, ACS and AMI group were markedly higher than that in CTL and SAP group when DCs were at levels of 2 × 10^5/mL （P〈0.05）,and that of ACS and AMI group were significantly higher than UAP group （P〈0.01）. In terms of the IL-12 and IFN- a levels in the supernatant of the mixed lymphocyte （DCs and T-cells） culture medium, UAP, ACS and AMI group were remarkably higher than CTL and SAP group,and ACS and AMI group were significantly higher than UAP group （P〈0.01）, AMI group was notably higher than ACS group（P〈0. 05）. Conelusiun The variation in quantity, percentage, and functions of peripheral DCs could reflect to some extent the progression of coronary artery plaques in CAD patients.