急性心肌梗死患者辅助性T淋巴细胞亚群Th1/Th2表达的变化及其临床意义

Changes and clinical significance of helper lymphocyte T subsets in patients with acute myocardial infarction

目的:对比分析急性心肌梗死(AMI)患者、造影正常的胸痛患者外周血中Th1,Th2细胞的数量及血浆细胞因子IFN-γ,IL-4水平的差异,从而进一步探讨辅助性T淋巴细胞参与的免疫炎症反应与AMI之间的关系.方法:密度梯度离心法分离来自15例AMI患者、15例造影正常的胸痛患者冠脉内及外周血液中的单个核细胞,细胞荧光染色后用流式细胞仪检测Th1,Th2在血液中的比例,ELISA检测血浆中Th1/Th2分泌的细胞因子IFN-γ,IL-4的含量,分析患者Th1/Th2的变化.结果:AMI患者冠脉阻塞段血液中Th1,IFN-γ含量高于入院时外周血(P<0.05);AMI入院时外周血中Th1,IFN-γ含量高于造影正常的胸痛患者外周血(P<0.05).造影正常的胸痛患者冠脉血Th1,IFN-γ含量与外周血相比无统计学意义.AMI患者冠脉阻塞段血液中Th2,IL-4含量高于入院时外周血(P<0.05).AMI入院时外周血中Th2含量高于造影正常的胸痛患者外周血(P<0.05).AMI入院时外周血中IL-4含量与造影正常的胸痛患者外周血中含量相比无统计学意义;造影正常的胸痛患者冠脉血中Th2,IL-4含量与外周血相比无统计学意义.结论:局部CD4+辅助性T淋巴细胞亚群Th1,Th2的失衡,与AMI和动脉粥样硬化的免疫炎症反应密切相关.

AIM： To investigate the differences of Thl and Th2 cell numbers as well as the plasma levels of IFN-γ and IL-4 between patients with acute myocardial infarction （AMI） and the patients with chest pain but normal coronary arteriongraphy （control group ）, and to study the relationship between helper lymphocyte T involved immune-inflammatory reactions and AMI. METHODS： Density gradient centrifugation was employed to isolate mononuclear cells from AMI patients （n = 15 ） and patients with chest pain but normal coronary arteriongraphy（ n = 15 ）. Flow cytometric analysis was applied to detect the numbers of Thl and Th2 and ELISA was used to analyze the plasma levels of IFN-γ and IL-4. RESULTS ： The cell numbers of Thl and plasma levels of IFN-γ were significantly higher in occlusion coronary artery compared with those in peripheral blood in AMI patients （ P 〈 0. 05）, but the levels of Thl and IFN-γ were significantly higher in peripheral blood of AMI patients than those in control group （ P 〈 0.05 ）. However, no statistically significant difference was observed between the levels of Thl and IFN-γ in coronary artery and peripheral blood of control group. The cell numbers of Th2 and plasma levels of IL-4 were also significantly higher in occlusion coronary artery compared with those in peripheral blood in AMI patients （P 〈 0.05 ）, while the levels of Th2 were higher in peripheral blood of AMI patients than those in control group （P 〈 0.05）. No statistically significant difference was found between the levels of IL-4 in peripheral blood of AMI patients and those in control group, and no statistically significant difference was observed between the levels of Th2 and IL-4 in coronary artery and peripheral blood of control group. CONCLUSION： Thl and Th2 subsets of CD4^＋ T lymphocytes may play important roles in immune-inflammatory reactions in AMI and atherosclerosis.