外周血T细胞亚群构成比例与冠状动脉粥样硬化的关系

The Correlation Between Peripheral Blood T Lymphocyte Subgroup Proportion and the Severity of Coronary Atherosclerosis

目的探讨冠心病患者外周血T细胞亚群构成比例与冠状动脉粥样硬化病变程度的关系,为T淋巴细胞介导的免疫炎症反应诱导斑块进展提供依据。方法选择2012年6月至2012年12月在南方医科大学珠江医院心内科住院经冠状动脉造影术检查及治疗患者57例,其中造影检查正常13例(对照组),稳定型心绞痛14例,不稳定型心绞痛15例,急性心肌梗死15例。采用流式细胞仪检测外周血CD3+细胞占淋巴细胞比例,CD4+、CD8+细胞占T淋巴细胞比例,以及CD4+CD25+Treg和CD4+CD28-T细胞占CD4+T细胞比例,评价各组间差异,并对外周血T淋巴细胞亚群与冠状动脉粥样硬化病变程度(改良Gensini评分)进行相关性分析。结果稳定型心绞痛组、不稳定型心绞痛组以及急性心肌梗死组患者CD3+细胞占淋巴细胞比例明显高于对照组(均P<0.05);与对照组和稳定型心绞痛组相比,不稳定型心绞痛组以及急性心肌梗死组CD4+及CD8+细胞占CD3+细胞比例差异有统计学意义(均P<0.05);CD4+CD25+Treg及CD4+CD28-T细胞占CD4+细胞比例差异也有统计学意义(均P<0.05)。外周血CD3+T细胞与Gensini评分呈显著正相关(r=0.608,P<0.01);CD4+T细胞与Gensini评分呈显著正相关(r=0.624,P<0.01);CD8+T细胞与Gensini评分呈显著负相关(r=-0.548,P<0.01);CD4+CD25+Treg细胞与Gensini评分呈显著负相关(r=-0.617,P<0.01);CD4+CD28-T细胞与Gensini评分呈正相关,但相关关系不大(r=0.399,P<0.01)。结论 T淋巴细胞亚群广泛参与了动脉粥样硬化的发生发展,对冠心病临床危险分层有一定的预测价值。

Aim To assess the correlation between the peripheral blood T cell subgroup proportion and the degree of coronary atherosclerosis in patients with coronary heart disease; to provide the evidence for the T lymphocyte mediating immune inflammation, and inducing plaque progression. Methods Fifty-seven patients were enrolled after routine and coronary angiography examinations between June 2012 and December 2012. The proportion of peripheral blood CD3 ＋ cell in peripheral blood lymphocyte, and CD4 ＋ , CD8 ＋ cell in the T lymphocyte, and CD4 ＋ CD25 ＋ Treg, CD4 ＋ CD28 - T cell in the CD4 ＋ T cells, were detected by flow cytometry using five＇color fluorescent markers. Correlation between the peripheral blood T lymphocyte subgroup and the degree of coronary atherosclerosis （ modified Gensini standard） was ana- lyzed. Results The proportion of peripheral blood CD3 ＋ cell in stable angina pectoris（SAP） group, unstable angina peetoris（UAP） group and acute myocardial infarction （AMI） group were significantly higher than those in control group （ all P 〈 0. 05 ）. The proportion of CD4 ＋ cell and CD8 ＋ cell in UAP group and AMI group were significantly different compared with those in control group and SAP group （ all P 〈 0. 05 ）. The proportion of CD4 ＋ CD25 ＋ Treg and CD4 ＋ CD28- cell in UAP group and AMI group were significantly different compared with those in control group and SAP group （ all P 〈 0. 05 ）. The peripheral blood CD3 ＋ cell were positively correlated with Gensini score （ r = 0. 608, P 〈 0. 01 ）. The CD4 ＋ cell were positively correlated with Gensini score （ r = 0. 624,P 〈 0.01 ）. The CD8 ＋ cell were negatively correlated with Gensini score （ r = - 0. 548, P 〈 0.01 ）. The CD4＋ CD25 ＋ Treg were negatively correlated with Gensini score （r= -0.617,P〈0.01）. The CD4＋CD28-T cell were positively correlated with Gensini score（r =0. 399,P〈0.01）. Conclusions T lymphocyte subgroup plays an important role in the developmant and progression of atherosclerosis, and has certain prospective value in the clinical evaluation of the severity of the coronary disease.