T淋巴细胞亚群变化与冠心病患者心力衰竭程度的相关性分析

Correlation analysis between T lymphocyte subgroup changes and heart failure degree in patients with coronary heart disease

目的探讨外周血T淋巴细胞亚群改变与冠心病(CHD)患者心衰程度的相关性。方法选取2015年6月~2017年12月在赣州市立医院接受治疗的36例CHD患者为CHD组;选取同期在赣州市立医院检查不符合冠心病的临床诊断标准且心功能正常的健康人36例作为对照组。采用抗原抗体的特异性结合玻片法测定T淋巴细胞亚群(CD3+,CD4+,CD8+,CD4+/CD8+),并进行分析比较。结果CHD组外周血CD4+T细胞、CD4+/CD8+值均明显低于对照组,差异有统计学意义(P<0.05);CHD组CD8+T细胞明显高于对照组,差异有统计学意义(P<0.05)。从心功能Ⅱ级到心功能Ⅳ级,随着心衰程度加重CD3+、CD4+值及CD4+/CD8+比值呈下降趋势,而CD8+值呈上升趋势。Spearman秩分析法分析显示,外周血CD3+、CD4+T细胞值及CD4+/CD8+比值与CHD患者心衰程度均成负相关(r=-0.819、-0.829、-0.757,P<0.05),而CD8+T淋巴细胞值则与心衰程度成正相关(r=0.838,P<0.05)。结论CHD患者外周血T淋巴细胞亚群发生异常改变,T淋巴细胞亚群的改变与CHD患者心衰程度相关,CHD患者外周血T淋巴细胞亚群计数值可作为心衰严重程度等病情评估的参考指标。

Objective To investigate the correlation between the change of T lymphocyte subsets in peripheral blood and the degree of heart failure in patients with coronary heart disease (CHD). Methods A total of 36 Patients with CHD treated in Ganzhou Municipal Hospital from June 2015 to December 2017 were selected as CHD group, during the same period, 36 healthy people who did not meet the clinical diagnostic criteria of coronary heart disease and had normal cardiac function in Ganzhou Municipal Hospital were selected as the control group. T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+) were determined by specific combination of antigen antibodies, and compared with the glass sheet method. Results The CD4+ value and CD4+/CD8+ value of peripheral blood in the patients with CHD group were significantly lower than those in the control group, and the differences were statistically significant (P<0.05). The CD8+ value of CHD group was significantly higher than that of control group, the difference was statistically significant (P<0.05). From the cardiac function Ⅱ level to the cardiac function Ⅳ level, with the increase of heart failure degree CD3+, CD4+ value and CD4+/CD8+ ratio showed a decreasing trend, while the CD8+ value showed an upward trend. Spearman rank correlation analysis showed that the CD3+, CD4+T cell value and CD4+/CD8+ ratio of peripheral blood were negatively correlated with the degree of heart failure in patients with CHD (r=-0.819,-0.829,-0.757, P<0.05), while CD8+T Lymphocyte values were positively correlated with the degree of heart failure (r=0.838, P<0.05). Conclusion Abnormal changes of T lymphocyte subsets in peripheral blood of patients with CHD have occurred, and changes of T lymphocyte subsets are related to the degree of heart failure in patients with CHD. The count value of T lymphocyte subsets in peripheral blood of patients with CHD can be used as a reference index for the evaluation of the severity of heart failure.