不稳定性心绞痛患者介入治疗围术期CD4 T淋巴细胞磷酸酶基因表达的变化

PTEN expression in CD4 T lymphocytes of unstable angina pectoris patients during perioperative PCI

目的：探讨不稳定性心绞痛患者PCI围术期CD4 T淋巴细胞张力蛋白同源第10染色体丢失的磷酸酶基因（PTEN ）表达的变化。方法连续入选拟行择期PCI的不稳定性心绞痛患者42例，分别于PCI术前、术后16～24 h抽取新鲜外周血20 ml ，免疫磁珠法分选出CD4 T淋巴细胞，荧光定量PCR检测PTEN mRNA表达，蛋白免疫印迹法检测PTEN蛋白表达，酶联免疫吸附法检测 TNF-α及白细胞介素10（IL-10）炎性相关因子的表达。结果与PCI术前比较，PCI术后患者肌钙蛋白I高于正常高值的发生率为45．4％；与PCI术前比较，PCI术后血浆TNF-α水平明显升高，PTEN mRNA、PTEN蛋白和IL-10明显下降，差异有统计学意义（P＜0．05，P＜0．01）。直线相关分析显示，PTEN蛋白与TNF-α呈负相关（r＝-0．874，P＜0．01），与IL-10呈正相关（r＝0．732，P＜0.05）。结论PCI术可能通过下调PT EN的表达，促进相关炎性因子的分泌，从而诱发心肌炎症损伤。

Objective To study the PTEN expression in CD4 T lymphocytes of unstable angina pectoris patients during perioperative PCI .Methods Forty-two unstable angina pectoris patients who were going to undergo PCI were enrolled in this study .Peripheral blood samples were taken before and 16-24 h after PCI .CD4 T lymphocytes were isolated using the magnetic cell sorting system .Expression of PTEN mRNA and protein was detected by RFQ-PCR and Western blot respectively .Serum levels of TNF-α and IL-10 were measured by ELISA .Results The incidence of cTnI was 45 .4% higher while the expression level of PTEN mRNA and protein was significantly lower after PCI than before PCI .The serum TNF-αlevel was significantly higher while the serum IL-10 level was significantly lower after PCI than before PCI （P〈0 .05 ,P〈0 .01） .Linear correlation analysis showed that PTEN protein expression was negatively related with serum TNF-αlevel （r= -0 .874 ,P〈0 .01） and positively related with serum IL-10 level （r= 0 .732 ,P〈0 .05） . Conclusion PCI promotes secretion of inflammatory factors by down-regulating PTEN expres-sion ,thus inducing myocardial inflammation injury .