风湿性心脏病细胞免疫及调控失衡初探

Preliminary study of cytoimmune regulatory disturbances in rheumatic heart disease

目的 :探讨风湿性心脏病 (RHD)细胞免疫是否存在异常及其特点 ,为 RHD的早期免疫诊断及今后的免疫疗法提供依据。方法 :对 41例 RHD和 44例 RHD伴风湿活动 (RF)患者的 T淋巴细胞亚群、淋巴细胞转化率、自然杀伤 (NK)细胞数量及活性 ,HL A- DR抗原遗传位点进行了测定 ,并与正常对照组 (5 0例 )比较。结果 :RHD和 RF组细胞免疫功能活性增强 ,表现为 CD4数量增加 ,CD8数量减少 ,CD4/ CD8比值增大 ,与正常对照组比较 P <0 .0 5和 P <0 .0 1;RF组淋巴细胞转化率较正常对照组和 RHD组高 (P <0 .0 1) ,NK细胞数量增加 ,但活性降低 (P <0 .0 1和 P <0 .0 5 ) ;RF和 RHD组 HL A- DR4抗原呈高频分布 (5 3.6 %和 47.7% ) ,DR5 呈低频分布(14.6 %和 15 .9% ) (P <0 .0 1)。结论 :RHD存在细胞免疫功能异常 ,且发生自身免疫趋式 ,其机制可能是细胞免疫调控失衡。 DR4的高频分布 ,可作为

Objective:Of 85 patients,41 with rheumatic heart disease(RHD) 44 with acute rheumatic fever(RF) were studied in order to observe whether they had cytoimmume regulatory disturbances.Method:Tests of T lymphocyte subsets, T lymphocyte conversion rate, natural killer cell counts and functions, and frequencies specific histocompatibillity DR antigens (HLA DR 1 DR 7) were performed in 85 consecutive patients with RHD and in 50 normal control subjects.Result:Significant differences were noted for CD 4,CD 8 and CD 4/CD 8 ratio. The numbers of CD 4 cell were presented more in RHD, RF groups than normal control subjects (P< 0.05 ,< 0.01 ).Lymphocyte conversion rate was observed abnormally high in RF group 〔(87±22)%,P< 0.01 〕.Numbers of NK cell tended to be higher in RF patients than in control subjects(P< 0.01 ),but the functional activity of NK tended to be lower than other groups. Significant differences were noted for HLA DR 4、DR 5,high frequency for DR 4( 53.6 %, P< 0.01 ),low frequency for DR 5( 14.6 %, P< 0.01 ).Conclusion:Immune factors, especially cytoimmune regulatory disturbances may play a role in some cases of RHD and is worth for further investigation.