干扰素γ和CD68^+细胞在急性冠脉综合征的作用

Interferon Gamma and CD68^+ Cells in Acute Coronary Syndrome

目的:观察急性冠脉综合征(acute coronary syndrome,ACS)患者外周血单个核细胞中细胞因子干扰素γ(interferon gamma,IFN-γ)及CD68^+细胞比例的变化及其与冠状动脉病变严重程度的关系,并探讨其临床意义。方法:将经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)的患者,根据临床表现、心电图及冠状动脉造影结果等综合诊断分为急性心肌梗死(acute myocardial infarction,AMI)组30例、不稳定型心绞痛(unstable angina,UA)组30例、稳定型心绞痛(stable angina pectoris,SAP)20例和正常对照组20例。采用流式细胞仪检测各组患者外周血单个核细胞中IFN-γ及CD68^+细胞比例。结果:AMI组、UA组、SAP组外周血单个核细胞中IFN-γ的比例均明显高于正常对照组。PCI术后,AMI组、UA组外周血单个核细胞中IFN-γ的比例较术前明显降低。AMI组、UA组外周血单个核细胞中CD68^+细胞的比例均高于SAP组、正常对照组。ACS患者外周血单个核细胞中IFN-γ比例、CD68^+细胞比例均与Gensini评分成正相关。结论:ACS患者外周血中IFN-γ、CD68^+细胞比例明显升高,且均与Gensini评分成显著正相关,提示两者与冠状动脉严重程度有相关,且均参与ACS的发展,其检测有助于临床病情的评估与判断。

Objective： To investigate the changes of cytokine interferon gamma and CD68＋ cell proportion in peripheral blood mononuclear cells of patients with acute coronary syndrome and their correlation with the severity of coronary artery disease, and to explore its clinical significance. Methods：The patients with percutaneous coronary intervention were divided into acute myocardial infarction group（n=30）, unstable angina pectoris group （n=30）, stable angina pectoris （n=20） and normal control group （n=20）,which according to the clinical manifestations, ECG and coronary angiography results.Flow cytometry was used to detect the percentage of cytokines IFN-γ/and CD68＋ cells in peripheral blood mononuclear cells of each group. Results：The proportion of IFN-γ in the peripheral blood mononuclear cells of AMI group, UA group and SAP group was significantly higher than that in the control group. After percutaneous coronary intervention, AMI group and UA group of peripheral blood mononuclear cells in the proportion of IFN-γ reduced significantly compared with pre-operative. The proportion of CD68＋ cells in peripheral blood mononuclear cells of AMI group and UA group was higher than that in SAP group and normal control group. The proportion of IFN-γ and CD68＋ cell in peripheral blood mononuclear cells of ACS patients was correlated with Gensini score. Conclusions：The level of IFN-γ and CD68＋ cell ratio in peripheral blood of patients with ACS significantly increased, and significant positive correlation with Gensini score. It is suggested that IFN-γ and CD68＋ cell ratio in peripheral blood were closely related to the degree of coronary artery disease. The levels of IFN-γ and CD68＋ cell ratio concentrations in peripheral blood of patients with acute coronary syndromes are related to the progression of ACS. It is help to evaluate and judge the clinical condition.