不同治疗途径的急性心肌梗死病人淋巴细胞亚群表达变化分析

Analysis of the lymphocyte subsets expression in acute myocardial infarction patients treated with different treatment approaches

目的:分析急诊经皮冠脉介入治疗(PCI)与药物治疗两种途径的急性心肌梗死(AMI)病人淋巴细胞亚群表达情况,探讨AMI发病的免疫防御机制。方法:选取60例AMI病人作为观察组,其中30例行PCI+药物治疗(PCI组),另外30例采用常规药物治疗(药物组),并择同期健康体检中心30名无特殊治疗的健康者作为对照组。采集所有研究对象入院当日外周血以及治疗30 d后观察组门诊随访的外周血,通过流式细胞术测定淋巴细胞亚群表达情况,同时检测观察组当日外周血心肌肌钙蛋白I(cTnI)含量。结果:与对照组比较,观察组CD3^+CD8^+、CD19+B百分比增加,CD3^+CD4^+百分比及CD4^+/CD8^+比值降低,差异均有统计学意义(P<0.05~P<0.01);治疗30 d后,PCI组与药物组相比,淋巴细胞亚群表达结果与之相反,差异均有统计学意义(P<0.05~P<0.01);Pearson相关性分析显示,CD4^+/CD8^+比值与cTnI呈负相关关系(r=-0.53,P<0.05)。结论:淋巴细胞亚群参与AMI免疫炎性反应,PCI治疗使AMI病人心肌免疫炎性损伤得到不同程度修复。CD4^+/CD8^+比值与cTnI呈负相关,CD4^+/CD8^+比值越低,cTnI值越高,提示心肌损伤越严重,预后越差。

Objective:To compare the expression changes of lymphocyte subsets in acute myocardial infarction(AMI)patients treated with between emergency percutaneous coronary intervention(PCI)and drug,and explore the immune defence mechanism of AMI occurrence.Methods:Sixty AMI patients were set as the observation group[including 30 cases treatment with PCI combined with medication(PCI group)and 30 cases treatment with conventional medication(medication group),and 30 healthy people treated without special treatment were set as the control group.The peripheral blood of two groups were collected on the day of admission,the peripheral blood in the observation group were collected after 30 days of following-up.The expression of lymphocyte subsets was determined by flow cytometry,and the content of troponin I(cTnI)in peripheral blood of the observation group was also detected.Results:Compared with the control group,the percentages of CD3^+CD8^+and CD19+B lymphocytes increased,the percentages of CD3^+CD4^+and CD4^+/CD8^+ratio decreased in the observation group,and the differences of whose were statistically significant(P<0.05 to P<0.01).After 30 days of treatment,the expression of lymphocyte subsets in the PCI group was contrary to that in the drug group,and the difference of which was statistically significant(P<0.05 to P<0.01).The results of Pearson correlation analysis showed that the CD4^+/CD8^+ratio was negatively correlated with cTnI(r=-0.53,P<0.05).Conclusions:Lymphocyte subsets are involved in the inflammatory response of AMI.The PCI therapy can repair myocardial immune inflammatory injury in AMI patients to different degrees.The CD4^+/CD8^+ratio is negatively correlated with cTnI.The lower the CD4^+/CD8^+ratio is,the higher the cTnI is,and which suggests that the more severe the myocardial damage is,the worse the prognosis is.