急性冠脉综合征患者辅助性T细胞亚群的变化及意义

Dynamic changes of Th1/Th2 subsets in patients with acute coronary syndrome

目的探讨急性冠脉综合征(ACS)患者外周血辅助性T细胞亚群(Th1/Th2)的变化及意义。方法采用流式细胞术和实时定量PCR的方法检测22例急性心肌梗死(AMI)、25例不稳定型心绞痛(UA)、20例稳定型心绞痛(SA)患者和25例正常对照外周血Th1/Th2细胞频率及相关基因T-bet、STAT4(signal transducer and activator of transcription4)、干扰素γ(inter-feronγ,IFN-γ)、GATA3和白介素-4(interleukin-4,IL-4)mRNA的表达。结果①与SA组和对照组相比,ACS组(包括UA组和AMI组)患者外周血中Th1细胞频率显著增高(P<0.01),而Th2细胞频率的变化无统计学意义;②ACS组(包括UA组和AMI组)患者Th1细胞相关基因T-bet、STAT4和IFN-γ的mRNA表达显著高于SA组和对照组(P<0.01),而Th2细胞相关基因IL-4和GATA3的mRNA表达在各组之间未见明显差异。结论 Th1/Th2失衡可能参与急性冠脉综合征的发生发展。

Objective To explore the changes of Th1/Th2 subsets in acute coronary syndrome（ACS） and its significance. Methods In 22 patients with acute myocardial infarction（AMI） ,25 patients with unstable angina（UA） ,20 patients with stable angina（SA） and 25 normal controls,the frequencies of the peripheral Th1/Th2 cell and the mRNA expression levels of related gene T-bet,signal transducer and activator of transcription 4（STAT4） ,interferon（IFN） -γ,GATA3 and interleukin（IL） -4 were measured by flow cytometry and real-time quantitative PCR,respectively. Results ①Compared with SA patients and normal controls,the frequencies of Th1 cell in ACS patients（UA and AMI patients） significantly increased（P0.01） ,while there was no significant difference in frequencies of Th2 cell among 4 groups.② The mRNA expression levels of Th1 related gene（T-bet,STAT4 and IFN-γ） were significantly higher in ACS patients（UA and AMI patients） than those in SA patients and controls（P0.01） ,while there was no significant difference in Th2 related gene expression（IL-4 and GATA3） among 4 groups. Conclusion Th1/Th2 imbalance may participate in the development of acute coronary syndrome.