风湿性心脏病心功能不全时红细胞免疫状态与过氧化脂质的改变

The Change of Erythrocyte Immune State and Lipid Peroxide in Patients of Rheumatic Heart Diseases with Cardiac Insufficiency

目的：探讨风湿性心脏病（风心病）心功能不全时红细胞免疫状态。 方法：将９８例患者按心功能（ＮＹＨＡ）分级分为轻度心力衰竭（心衰）组３６ 例、中度心衰组３３ 例及重度心衰组２９例，另有健康对照组４８ 例，检测其红细胞受体花环率、红细胞免疫复合物花环率及红细胞免疫增强因子、红细胞免疫抑制因子、过氧化脂质的变化。 结果：心衰患者红细胞受体花环率、红细胞免疫复合物花环率和红细胞免疫增强因子均显著下降（Ｐ＜ ０．０１），而红细胞免疫抑制因子、过氧化脂质则明显升高（Ｐ＜ ０．０１），其变化且随心衰程度加重而更加显著。相关分析表明：红细胞受体花环率与红细胞免疫增强因子呈显著正相关（ｒ＝ ０．９２，Ｐ＜ ０．０１），与红细胞免疫抑制因子、过氧化脂质呈显著负相关（ｒ＝ － ０．８７、－ ０．８１，Ｐ＜ ０．０１）。 结论：提示风心病心功能不全时存在红细胞免疫功能下降。

Objective: To study the erythrocyte immune state in patients of rheumatic heart diseases with cardiac insufficiency. Methods: According to the cardiac function (NYHA Standard) situations,98 patients with cardiac insufficiency were divided into 3 groups: mild type( n =36),median type( n=33 )and severe type( n=29 ).Plasma red blood cell C3b receptor rosette(RBC C3bRR),red cell blood immune complex rosette(RBC ICR),enhancing factor(EF),inhibitory factor(IF)and lipid peroxide(LPO)were determined in all 3 groups. Results:RBC C3bRR,RBC ICR and EF in total patients with cardiac insufficiency were significantly decreased( p <0 01),while IF and LPO were significantly increased( p <0 01).These changes became more obviously along with the cardiac function decreased.The correlation analysis showed:That RBC C3bRR was related positively to EF( r =0 92, p <0 01),but negatively to IF and LPO( r =-0 87、-0 81, p <0 01). Conclusion: The results suggest that the erythrocyte immune function in patients of rheumatic heart diseases with cardiac insufficiency is decreased,which is in relation to the change of erythrocyte immune regulation factors and the increase in LPO.