血清IL-6及外周血Th17细胞在合并RA的AMI患者中的临床意义

Clinical significance of IL-6 and Th17 cells in acute myocardial infarction patients combined with rheumatoid arthritis

目的探讨急性心肌梗死(AMI)合并类风湿关节炎(RA)与不合并类风湿关节(RA)患者的临床指标及血清白介素-6(IL-6)水平和外周血辅助性T细胞17(Th17)的差异。方法选择合并RA的AMI患者28例,不合并RA的AMI患者28例,收集这些患者的基线资料,并测定患者血清IL-6水平和外周血淋巴细胞Th17细胞亚群,比较2组差异。结果合并RA的AMI患者血清IL-6水平高于不合并RA的AMI患者(P<0.05),身体质量指数(BMI)低于不合并RA的AMI患者(P<0.05);Th17细胞在AMI患者外周血CD 4 T细胞中比例显著升高,但在合并及不合并RA的AMI患者中无统计学意义;合并RA的AMI患者的血清IL-6水平显著高于不合并RA的AMI患者,且在不合并RA的AMI患者中,血清IL-6水平与AMI患者冠脉病变程度呈正相关(P<0.05)。结论血清IL-6可能是不合并RA的AMI患者冠脉病变进展的重要炎症因子,而Th17细胞可能是RA患者发生AMI的一个潜在致病因素。

Objective To explore the difference of clinical charateristics and Th17 cell and serum IL - 6 between patients in acute myocardial infarction with or without rheumatoid arthritis. Methods 28 patients with AMI combined RA and another 28 AMI patients were selected, and the baseline data were collected. ELISA and Flow cytometry were used to test Th17 and IL -6. Results The level of IL -6 was higher in AMI patients combined with RA while BMI was lower in these patients compared with AMI patients without RA （ t = -2. 535 ,P 〈0.05 ;t =2. 428 ,P 〈0.05 ,respectively）. The percentage of Th17 producing in CD4 T cell was higher in patients with AMI, but no significant difference was shown in subgroups with or without RA. The level of serum IL - 6 was higher in AMI patients combined with RA, and positive correlated with SYNTAX score in AMI patients without RA （ r =0. 585, P 〈 0.05）. Conclusion Serum IL - 6 probably is an inflammatory factor which could promote atherosclerosis in AMI patients without RA. Th17 cell is a potential pathogenic marker in process of atherosclerosis in AMI patients with RA.