冠心病患者外周血Tim-3及CD4^+、CD8^+的表达

Expressions of Tim-3 and CD4^+ and CD8^+ T cells in peripheral blood from patients with coronary heart disease

目的探讨冠状动脉粥样硬化性心脏病(coronary heart disease,CHD)患者外周血T细胞免疫球蛋白及黏蛋白-3(T cell immunoglobulin and mucin-domain containing moleculesfamily-3,Tim-3)及CD4^+、CD8^+的表达。方法 51例CHD为研究对象,其中稳定性心绞痛患者27例,急性冠脉综合征患者24例,25例经冠脉造影证实的非CHD者为健康对照组,患者在起病入科时抽取外周血,采用酶联免疫吸附法(enzyme-linked immunoassay,ELISA)检测Tim-3浓度,流式细胞仪检测外周血T细胞亚群CD4^+、CD8^+、CD4^+/CD8^+的表达。结果与健康对照组比,稳定性心绞痛组、急性冠脉综合征组外周血Tim-3浓度降低,且急性冠脉综合征组浓度更低,差异有统计学意义(P<0.05);与健康对照组比,稳定性心绞痛组、急性冠脉综合征组外周血CD4^+比例升高,CD8^+比例降低,CD4^+/CD8^+比值升高,且急性冠脉综合征组变化更大,差异有统计学意义(P<0.05)。结论冠心病患者起病时外周血Tim-3浓度降低,CD4^+比例升高,CD8^+比例降低,CD4^+/CD8^+比值升高,而且病情越重数值变化越大。

Objective To investigate the expressions of T cell immunoglobulin and mucin-domain containing moleculesfamily-3 （Tim-3） and CD4^＋ and CD8^＋ T cells in peripheral blood from patients with coronary heart disease （CHD）. Methods 51 CHD patients were divided into two groups： stable angina pectoris group （27 patients） and acute coronary syndromes group （24 patients）. Another 25 healthy subjects confirmed by coronary angiography were selected as a control group. Peripheral blood was drawn on admission. Enzyme-finked immunosorbent assay was used to detect the concentration of Tim-3. Flow cytometry was applied to detect the expressions of CD4^＋ and CD8^＋. Results As compared with the healthy control group, the concentration of Tim-3 and the proportion of CD8^＋ in stable angina pectoris group and acute coronary syndrome group were reduced, and those in acute coronary syndrome group were lower. The differences were statistically significant （P 〈 0.05）. As compared with the healthy control group, the proportion of CD4^＋ and the ratio of CD4^＋/CD8^＋ of stable angina pectoris group and acute coronary syndrome group were increased, while those in acute coronary syndrome group were higher. The differences were statistically significant （P 〈 0.05）. Conclusions At the onset of CHD, the concentration of Tim-3 and the proportion of CD8^＋ in peripheral blood are reduced, but the proportion of CD4^＋ is increased. The more severe the disease, the greater changes the values.