辅助性T细胞17、辅助性T细胞17/辅助性T细胞1比例在急性冠状动脉综合征的变化及临床意义

Clinical Significance and the Alteration of T-Helper(Th) 17 and Th17/Th1 Cells' Proportion in Patients with Acute Coronary Syndrome

目的探讨急性冠状动脉综合征(ACS)患者外周血辅助性T细胞(Th)17、Th17/Th1比例及血浆中白细胞介素17(IL-17)和IL-22的变化及意义。方法选择冠心病患者50例,其中急性心肌梗死(AMI)组20例,不稳定型心绞痛(UA)组15例,稳定型心绞痛(SA)组15例;健康查体者15例作为正常对照组。采用流式细胞分析法,检测各组外周血Th17、Th17/Th1细胞占CD4+T细胞比例。采用酶联免疫吸附法检测患者血浆IL-17和IL-22的浓度。结果AMI组和UA组外周血Th17细胞比例[(2.98%±1.01%)和(2.63%±0.61%)]、Th17/Th1细胞比例[(0.71%±0.35%)和(0.66%±0.31%)]均明显高于SA组及正常对照组(均P<0.05)。AMI组血浆IL-17(24.41±7.95 ng/L)和IL-22(34.18±7.04 ng/L)浓度均显著高于SA组和正常对照组(均P<0.05);UA组血浆IL-17浓度(22.86±8.62ng/L)显著高于正常对照组,血浆IL-22浓度(28.98±4.35 ng/L)显著低于AMI组而高于正常对照组。ACS组IL-22浓度与IL-17浓度呈显著正相关(r=0.422,P<0.01),且ACS组Th17细胞与IL-17(r=0.722,P<0.01)、IL-22(r=0.400,P<0.01)浓度均呈显著正相关。结论 Th17细胞可能参与动脉粥样斑块不稳定和ACS的发病。Th17细胞及其相关炎性因子IL-17、IL-22可作为诊断急性心血管事件发生的辅助检测指标。

Aim To investigate the alteration and clinical significance of T-helper17 cells （Thl7）, interleukin （IL）-17 and IL-22 in patients with aeute coronary syndrome （ACS）. Method 50 patients were divided into three groups ： acute myocardial infarction （ AMI, n = 20 ） , unstable angina （ UA, n = 15 ） , stable angina （ SA, n = 15 ） ; 15 healthy subjects from physical examination were used as normal control group. The peripheral blood of Thl7 and Thl7/ Thl cells accounted for the proportion of CD4 ＋ T cells were detected by flow eytometry （ FCM ） ; the concentration of plasma IL-17 and IL-22 were detected by enzyme-linked immunosorbent assay （ELISA）. Results The proportion of Thl7 cells in AMI group and UA group （ （2.98%±1.01% ） and （2.63%±0. 61% ） ）, also the proportion of Thl7/Thl cells in AMI group and UA group （ （0.71%±0. 35% ） and （0. 66%±0. 31% ） ）, were both significantly higher than SA group and normal control group （both P 〈 0. 05 ） ; IL-17 and IL-22 concentration in AMI group （IL-17 ： 24.41 ± 7.95 ng/L; IL- 22 ： 34. 18 ± 7.04 ng/L） were significantly higher than SA group and normal control group （ both P 〈 0. 05 ）. IL-17 concentration in UA group （22. 86 ± 8.62 ng/L） was significantly higher than normal control group; IL-22 eoncentration in UA group （28.98 ±4. 35 ng/L） was significantly lower than AMI group, significantly higher than normal control group. In ACS group, there was a significant positive correlation between IL-17 concentration and IL-22 concentration （ r = 0.422, P 〈 0. 01 ）, also there was a significant positive correlation between the proportion of Thl7 cells and IL-17 concentration（ r =0. 722, P 〈 0. 01 ）, IL-22 concentration（ r = 0. 400, P 〈 0. 01 ）. Conclusions Thl7 cells may be involved in the in- cidence of the atheroselerotie plaque instability and ACS. IL-17 and IL-22 can be used as a secondary detection of ACS diagnosis.