心衰并呼衰患者外周血细胞免疫功能状态的研究

Study of immuny function of peripheral blood of patients with heart failure and respiratory failure

目的探讨不同心功能和心力衰竭并呼吸衰竭患者外周血T、Th、Ts、Th/Ts、TNF-α和TGF-β的表达变化及其临床意义。方法采用流式细胞术和酶联免疫吸附法分析65例Ⅱ级、Ⅲ级、心力衰竭合并呼吸衰竭病人及40例健康人外周血的表达和变化情况。结果健康人、心功能Ⅱ级Ⅲ级心力衰竭合并呼吸衰竭等组之间外周血总T细胞未见明显变化;Ts与心力衰竭程度呈正相关(P<0.05);Th与心力衰竭程度呈负相关(P<0.05)。Th/Ts降低与心力衰竭程度呈负相关(P<0.05)。并且心力衰竭合并呼吸衰竭时这种趋势表现得更加明显。心功能Ⅲ和心力衰竭合并呼吸衰竭血浆中TNF-α和TGF-β的含量高于对照组(P<0.05);心力衰竭合并呼吸衰竭病人血浆中TNF-α和TGF-β高于心功能Ⅱ(P<0.05)。结论炎症反应是加重心力衰竭的重要因素,检测心力衰竭合并呼吸衰竭患者外周血中T细胞亚群和炎症因子的变化情况有助于指导治疗和预测预后。

Objective To investigate the expression and clinical significance of T,Th,Ts,Th/Ts,TNF-α and TGF-β in patients with different cardiac function and respiratory failure.Methods The data were analyzed of T,Th,Ts,Th/Ts,TNF-α and TGF-β in 65 cases of cardiac function Ⅱ,Class Ⅲ,heart failure with respiratory failure and 40 healthy human with flow cytometry and ELISA.Results There was no difference in the cardiac function Ⅱ,heart function Ⅲ,heart failure with respiratory failure in T cells.Ts was positively correlated with the severity of heart failure（r=0.913,P0.05）;Th was negatively correlated with severity of heart failure Correlation（r=-0.730,P0.05）.Th/Ts was negatively correlated with the severity of heart failure（r=-0.889,P0.05）.Patients with respiratory failure and heart failure showed more evidently the above-mentioned difference.The level of TNF-α and TGF-β in patients of heart failure III and respiratory failure was higher than that in healthy group（P0.05）;heart failure with respiratory failure group was higher than that in cardiac function Ⅱ（P0.05）.Conclusion The inflammatory response is an important factor for increasing heart failure.It was very important to inspect T cell subsets and inflammatory factors in patients with heart failure and respiratory failure,which may help guide the evaluation of its prognossi and treatment.