T细胞亚群及相关细胞变化在急性冠脉综合征发病中的意义

Significances in changes of T cell subsets and their related cytokines in acute coronary syndromes

目的探讨急性冠脉综合征(ACS)患者外周血Th17、Th22及Treg细胞频数及相关细胞因子水平变化在ACS发生发展中的作用。方法连续收集本院急诊科自2015年收治的ACS患者71例,包括急性心肌梗死(AMI)患者46例,不稳定性心绞痛(UA)25例;稳定性心绞痛(SA)22例;以同期健康体检者30例作为对照组。采用流式细胞仪检测4组外周血Th17、Th22细胞及Treg细胞频数,以酶标仪检测患者血浆中相关细胞因子IL-17、IL-21、IL-22及IL-35。结果 AMI组及UA组外周血Th17、Th22细胞比例及其相关细胞因子IL-17、IL-21、IL-22较对照组、SA组均明显升高,差异均有统计学意义(P<0.05);AMI组及UA组Treg细胞及IL-35均低于SA组及对照组,差异均有统计学意义(P<0.05)。结论 Th22、Th17细胞比例和Treg细胞比例失衡及相关细胞因子变化可能与ACS斑块不稳定密切相关。

Objective To investigate the significance in changes of frequencies of Th17,Th22 and Treg cells and concentrations of their related cytokines in the peripheral blood of patients in the development of acute coronary syndrome. Methods We selected 71 cases ACS patients in the emergency department of our hospital from 2015 were consecutively collected,including 46 patients with acute myocardial infarction（ AMI）,25 patients with unstable angina,22 patients with stable angina（ SA）,at the same time,30 cases accepted physical examination with physical fitness were selected as healthy control group（ HC）. The frequencies of Th17 cells,Th22 cells and regular T cells in the peripheral blood were tested by flow cytometry instrument,and related cytokines were tested,including IL-17,IL-21,IL-22 and IL-35 by ELISA in plasma of patients. Results The levels of Th17,Th22 cells and their related cytokines,IL-17,IL-21 and IL-22 in AMI and UA groups were significantly higher than those in HC and SA groups,with the differences statistically significant（ P〈0. 05）; the levels of Treg cells and IL-35 in AMI group and UA group were lower than those in SA group and HC group,with the differences statistically significant（ P〈0. 05）. Conclusion The imbalance of Th22,Th17,Treg cells and their related cytokines may be closely associated with ACS plaque＇s instability.