冠心病患者免疫功能临床研究

Clinical research on immune function in patients with coronary heart disease

目的研究冠心病(CAD)患者机体细胞免疫及体液免疫功能紊乱与冠心病关系。方法以71例CAD患者为研究对象,其中包括19例急性心肌梗死设为AMI组、24例不稳定性心绞痛设为UAP组,28例稳定型心绞痛设为SAP组,并设立对照组21例,比较各组细胞免疫及体液免疫的功能状况。结果细胞免疫比较中AMI组、UAP组与对照组及SAP组比较CD3、CD8均出现下降,两两比较差异均有统计学意义(P<0.05),CD4也出现降低,但不支持差异有统计学意义(P>0.05),CD4/CD8AMI组与其他3组比较差异均有统计学意义(P<0.05),显示AMI组CD8下降程度较为显著;体液免疫比较中AMI组、UAP组与对照组及SAP组比较,IgG、C3、C4均出现升高,两两比较差异均有统计学意义(P<0.05),AMI组IgA也出现升高与其他3组比较差异均有统计学意义(P<0.05)。结论冠心病患者存在细胞免疫功能低下及CD4、CD8细胞功能失衡,体液免疫功能亢进,研究冠心病患者的免疫功能状态,对冠心病的防治有重要的临床意义。

Objective To study the relationship between cellular immunity and humoral immune dysfunction and coronary heart disease（CAD） in patients with CAD.Methods 71 CAD patients were selected,including 19 patients with acute myocardial infarction in AMI group,24 cases of unstable angina in UAP group,28 patients with stable angina pectoris in the SAP group,and a control group of 21 patients.The functional status of cellular immunity and humoral immunity were compared.Results Compared with the control group and SAP group,CD3 and CD8 level in cellular immunity were decreased in AMI group and UAP group,and the difference was statistically significant（P0.05）.CD4 level also decreased,but the difference was not significant（P0.05）.CD4/CD8 in AMI group compared with the other three groups was significantly different（P0.05）,and CD8 level was obviously reduced in AMI group.In humoral immune,compared with AMI group and UAP group,IgG,C3 and C4 level increased in the control group and SAP group,and the difference was significant（P0.05）.IgA level in AMI group was significantly higher than that in the other three groups（P0.05）.Conclusion The patients with coronary heart disease exist cellular immune disfunction,CD4 and CD8 cell function imbalance,and humoral immune hyperfunctioning.Research on the immune status of patients with coronary heart disease has important clinical significance on prevention and treatment of coronary heart disease.