ACS患者外周血LXA4与CD4+CD25+CD127-调节性T细胞水平的临床意义

Clinical Significance of Levels of LXA4 and CD4+CD25+CD127- Treg cells in Peripheral Blood in Patients with Acute Coronary Syndrome

目的探讨ACS患者入院时外周血脂氧素A4(LXA4)与CD4+CD25+CD127-调节性T细胞(Treg)水平在急性冠脉综合症患者中的作用及机制,探讨其在此类疾病诊断及预后方面作用。方法整群选取自2010年3月—2015年3月该院收治的154例ACS患者,其中49例急性非ST段抬高型心肌梗死(NSTEMI),53例急性ST段抬高型心肌梗死(STEMI)组,52例不稳定型心绞痛(UA)组。对照组选取同期该院健康体检者50例。采用酶联免疫吸附法(ELISA)和流式细胞分析法,检测各组外周血LXA4、CD4+CD25+CD127-Treg细胞水平,并进行相关性分析。结果 ACS组患者入院时外周血LXA4水平显著高于对照组(P<0.01);STEMI组患者外周血LXA4水平显著高于UA组及NSTEMI组(P值分别为<0.05,<0.05);ACS组患者入院时外周血CD4+CD25+CD127-Treg细胞占CD4+CD25+T细胞的百分率与对照组(P<0.01)相比显著较低;STEMI组患者外周血CD4+CD25+CD127-Treg细胞占CD4+CD25+T细胞的百分率与UA组及NSTEMI组(P值分别为<0.05,<0.05)相比显著较低;CD4+CD25+CD127-Treg细胞百分率和ACS患者血浆LXA4水平呈显著负相关(r=-0.653,P=0.004)。结论通过检测ACS患者的CD4+CD25+CD127-Treg细胞及LXA4水平,能够对ACS患者的分型及预后有一定的指导意义。

Objective To explore the mechanism of the levels of LXA4 and CD4+CD25+CD127- Treg cells in peripheral blood in patients with acute coronary syndrome (ACS) and discuss its role in diagnosis and prognosis of this kind of disease. Methods From March 2010 and March 2015, 154 ACS patients were enrolled, including 49 cases of acute non-ST-eleva-tion myocardial infarction (NSTEMI) as the NTESMI group, 53 cases of acute ST-elevation myocardial infarction (STEMI) as the STEMI group, 52 cases of unstable angina as the UA group. Other healthy people who received health check in the same period in this hospital were selected as the control group. Enzyme-linked immunosorbent assay (ELISA) and flow cy-tometry were used to detect the levels of LXA4 and CD4+CD25+CD127-Treg cells in peripheral blood in all the patients and the correlation analysis was conducted. Results The level of LXA4 at admission was higher in the all the ACS patients than in those in the control group(P<0.01), was higher in the STEMI group than in the UA group(P<0.05) and NTESMI group (P<0.05). The proportion of peripheral blood CD4+CD25+CD127-Treg cells in CD4+CD25+T cells at admission was obviously lower in all the ACS patients than those in the control group (P<0.01), was obviously lower in the STEMI group than in the UA group(P<0.05) and NTESMI group(P<0.05). The proportion of peripheral blood CD4+CD25+CD127-Treg cells was negatively correlated with the level of LXA4, (r=-0.653, P=0.004). Conclusion Detecting the level of CD4+CD25+CD127-Treg cells and LXA4 can provide guidance for the classification and prognosis of patients with ACS.