特发性心房颤动患者Th17细胞及其细胞因子的表达水平及相关性研究

Expression of Th17 cells and cytokines in patients with idiopathic atrial fibrillation

目的通过检测特发性心房颤动(AF)患者外周血Th17细胞及其细胞因子,探讨两者的相关性。方法选取2016年2月—2018年2月于玉林市第一人民医院心内科就诊的特发性AF患者80例,其中阵发性心房颤动(PAF)患者34例,慢性心房颤动(CAF)患者46例,选取年龄匹配的同期健康体检者80例作为对照组,流式细胞术检测患者外周血单核淋巴细胞Th17细胞百分率,ELISA法检测患者血清白细胞介素17(IL-17)、IL-6、IL-22及基质金属蛋白酶-9(MMP-9)水平,对患者的临床资料进行比较。结果 PAF组、CAF组及对照组基线资料比较,差异无统计学意义(P>0.05)。3组患者的Th17细胞百分率比较,差异有统计学意义(P<0.05);PAF组、CAF组高于对照组(P<0.05),CAF组高于PAF组(P<0.05)。3组患者IL-17、IL-6、IL-22、MMP-9浓度比较,差异有统计学意义(P<0.05);PAF组、CAF组IL-17、IL-6、IL-22、MMP-9高于对照组(P <0.05),CAF组IL-17、IL-6、MMP-9高于PAF组(P <0.05)。AF患者Th17细胞百分率与左心房内径呈正相关(P<0.05),与左心室射血分数呈负相关(P<0.05)。结论特发性AF患者外周血Th17细胞比例、IL-17、IL-6及IL-22升高,且升高水平与AF进程和心肌纤维化水平相关。

Objective To investigate the correlation between Th17 cells and cytokines in peripheral blood of patients with idiopathic atrial fibrillation(AF).Methods Totally 80 patients with AF admitted to department of cardiology in our hospital were enrolled,including 34 patients with paroxysmal AF(PAF)and 46 patients with chronic AF(CAF),and the other 80 persons with the same age in the health examination were the control group.Flow cytometry was used to detect the percentage of peripheral blood mononuclear lymphocyte(PBMCs)Th17 cells.The levels of serum interleukin IL-17,IL-6,IL-22 and matrix metalloproteinase-9(MMP-9)were detected by ELISA.The differences between the control group and the AF group were compared,and the correlation analysis was made.Results There were no significant difference in baseline data among PAF group,CAF group and control group(P>0.05).The percentage of Th17 cells in the PAF group and CAF group were higher than that in the control group(P<0.05),and the percentage of Th17 cells in the CAF group were higher than that in the PAF group(P<0.05).Compared to control group,the levels of IL-17,IL-6,IL-22 and MMP-9 were higher in PAF group and CAF group(P<0.05).The levels of IL-17,IL-6 and MMP-9 in the CAF group were higher than that in the PAF group(P<0.05).The percentage of Th17 cells in AF patients was positively correlated with left atrial diameter(LAD)and negatively correlated with left ventricular ejection fraction(LVEF)(P<0.05).Conclusions The percentage of Th17 cells and the levels of IL-17,IL-6 and IL-22 in peripheral blood of patients with idiopathic AF are increased and related to the process of AF and the level of myocardial fibrosis.