冠心病患者红细胞补体受体1介导的免疫复合物清除能力的改变

Ability of elimination of circulating immune complexes mediated by complement receptor 1 in patients with coronary heart disease

目的探讨参与红细胞补体受体1(CR1)介导的外周循环免疫复合物清除途径的几个重要成分在冠心病患者中是否存在异常改变。方法以拟诊冠心病入院中老年患者作为受试对象,对受试对象进行冠状动脉造影术,根据造影结果及临床分为:无冠状动脉病变对照组(10例)、心绞痛组(20例)、急性心肌梗死组(7例)。整理受试对象的一般资料,用流式细胞术检测外周血红细胞CR1与免疫复合物结合能力、红细胞CR1表达量,检测血脂、补体C3、C4等,并评价受试对象冠心病危险因素。结果 (1)各组受试对象均存在一种或多种冠心病危险因素;(2)各组受试对象在外周血红细胞CR1表达量上差异无统计学意义(荧光道数:对照组10.00±2.81,心绞痛组9.94±1.75,急性心肌梗死组10.60±2.66,均为P>0.05);(3)冠心病各组外周血红细胞CR1与免疫复合物结合能力较对照组显著降低(荧光道数:心绞痛组66.45±39.26和急性心肌梗死组62.5±43.52比对照组101.17±45.93,均为P<0.05);(4)各组受试对象在补体C3、C4水平上差异无统计学意义(C3:对照组0.99±0.21 g/L,心绞痛组1.14±0.32 g/L,急性心肌梗死组1.12±0.27 g/L,均为P>0.05;C4:对照组0.271±0.061 g/L,心绞痛组0.271±0.061 g/L,急性心肌梗死组0.271±0.061 g/L,均为P>0.05)。结论外周血红细胞CR1介导的IC清除能力降低与冠心病发病可能有关;冠心病外周血红细胞CR1介导的IC清除能力降低与血浆中C3、C4浓度无关。

Objective To explore whether there were alterations of elements involved in elimination of circulating immune complexes mediated by complement receptor 1 （ CR1 ） in patients with coronary heart disease. Methods Thirty-seven patients were enrolled and divided into three groups according to the results of coronary angiography and clinical data： （1） Normal coronary arteries group （n = 10）, （2） Angina group （n =20） or （3） acute myocardial infraction group （n =7）. Baseline characteristics of all the subjects were recorded. Flow cytometry were used to detect CR1 expression on erythrocytes, CRl-immune complexes binding ability on erythrocytes and concentration of C3 in plasma. Results （ 1 ） There were one or more risk factors of CHD for each patient in different group. （2） There were no significant differences in CR1levels among the three groups （ all P 〉 0. 05 ）. （ 3 ） The eliminating ability of circulating immune complexes mediated by CR1 in angina and acute myocardial infraction group was reduced significantly comparing to normal coronary artery group （ all P 〈 0.05 ）. （ 4 ） There were no significant differences for C3 or C4 concentrations among the three groups （ all P 〉 0. 05 ）. Conclusions Reduced eliminating ability of circulating immune complexes mediated by CR1 may associate with pathogenesis of CHD. No correlation between reduced immune complexes eliminating ability mediated by CR1 and C3 or C4 concentration in patients with coronary artery lesion.