外周血免疫细胞亚群和血清瘦素在合并代谢综合征的不稳定型心绞痛患者中的临床意义

Clinical significance of immune cell subsets in peripheral blood and serum leptin in unstable angina patients with metabolic syndrome

目的探讨合并代谢综合征(MS)的不稳定型心绞痛(UA)患者外周血免疫细胞亚群和血清瘦素水平的临床意义。方法 UA患者112例,其中合并代谢综合征组(观察组)患者59例和无代谢综合征组(对照组)患者53例,采用流式细胞术检测患者外周血T淋巴细胞亚群(CD_3^+、CD_4^+、CD_8^+、CD_4^+/CD_8^+)及NK细胞的水平;应用酶联免疫吸附法(ELISA)检测血清瘦素(LEP)水平。比较2组患者的主要心脏事件发生情况和病死率,分析代谢综合征对UA患者预后的影响。结果观察组CD_3^+、CD_4^+、CD_8^+及NK细胞水平较对照组明显降低(P<0.05),CD_4^+/CD_8^+水平较对照组显著升高(P<0.05),LEP水平高于对照组(P<0.05);再发心绞痛比例高于对照组(33.9%vs.17.0%,P<0.05),心源性病死率亦高于对照组(27.1%vs.11.3%,P<0.05)。结论合并代谢综合征的不稳定型心绞痛患者免疫调节功能受损较重,血清瘦素水平较高,这可能是导致心绞痛发作频率和心源性病死率升高的重要原因。

Objective To investigate the clinical significance of immune cell subsets in peripheral blood and serum leptin in unstable angina patients with metabolic syndrome .Methods 112 UA patients, including 59 patients with metabolic syndrome group （ observation group ） and 53 patients without metabolic syndrome group （ control group ） , peripheral blood T lymphocyte subsets （ CD3＋, CD4＋, CD8＋, CD4＋/CD8＋） and NK cell levels were measured by flow cytometry; enzyme linked immunosorbent assay （ELISA） were used to determine serum leptin （LEP） level.Major cardiac events and mortality were compared between the 2 groups, analyzed the influence of metabolic syndrome on the prognosis of patients with UA .Results Observation group’s CD3＋, CD4＋, CD8＋and NK cells was significantly lower than the control group （ P 〈0.05）, CD4＋/CD8＋levels significantly increased （ P 〈0.05）, the level of LEP is higher than that of control group （ P 〈0.05）;recurrent angi-na was higher than that of control group （33.9%vs.17%, P 〈0.05）, cardiac mortality was higher than the control group （27.1%vs.11.3%, P 〈0.05）.Conclusion The immunity regulation of unstable angina pectoris patients with type meta-bolic syndrome is impaired severely , higher serum leptin levels may be the cause of angina attack frequency and an important cause of cardiogenic mortality .