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目的:探讨不同类型冠心病患者外周血CD4+Foxp3+调节性T细胞(CD4+Foxp3+Treg)与细胞因子的变化及临床意义。方法:分别采用流式细胞术和酶联免疫吸附法(ELISA)检测21例急性心肌梗死、16例不稳定型心绞痛、21例稳定型心绞痛患者外周血CD4+Foxp3+Treg百分率及肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、白介素-10(interleukin-10,IL-10)、干扰素γ(interferon γ,IFN-γ)、白介素-4(interleukin-4,IL-4)、转化生长因子β(transforming growth factor β,TGF-β)的表达水平。结果:①急性冠脉综合征患者外周血CD4+Foxp3+Treg百分率显著低于正常人(P<0.001);②急性心肌梗死患者血浆TNF-α表达水平显著高于稳定型心绞痛患者(P<0.05),其CD4+Foxp3+Treg百分率与血浆IL-10水平呈显著正相关(r=0.751,P=0.005);③冠心病患者外周血CD4+Foxp3+Treg百分率与血浆TNF-α、IFN-γ、IL-4及TGF-β表达水平无显著相关性;④冠心病患者外周血CD4+Foxp3+Treg百分率与血清总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白无显著相关性(P>0.05)。结论:CD4+Foxp3+Treg的下降和TNF-α的升高可能参与急性冠脉综合征的发生发展。
Objective: To investigate the changes and clinical significance of CD4 + Foxp3 + regulatory T cells (CD4 + Foxp3 + Tregs) and cytokines in peripheral blood of patients with different types of coronary heart disease. Methods: Flow cytometry and enzyme-linked immunosorbent assay (ELISA) were used to detect the percentage of CD4 + Foxp3 + Treg and the level of tumor necrosis factor-alpha in 21 patients with acute myocardial infarction, 16 patients with unstable angina and 21 patients with stable angina pectoris (TNF-α), interleukin-10 (IL-10), interferon γ (IFN-γ), interleukin-4 (IL- Transforming growth factor β (TGF-β) expression levels. Results: ① The percentage of CD4 + Foxp3 + Treg in peripheral blood of patients with acute coronary syndrome was significantly lower than that of normal people (P <0.001); ② The level of TNF-α in patients with acute myocardial infarction was significantly higher than that of patients with stable angina (P <0.05) ), The percentage of CD4 + Foxp3 + Treg was positively correlated with plasma IL-10 level (r = 0.751, P = 0.005) .③The percentage of CD4 + Foxp3 + Treg in peripheral blood of patients with coronary heart disease was positively correlated with the levels of plasma TNF- , IL-4 and TGF-β expression levels; ④The percentage of CD4 + Foxp3 + Treg in peripheral blood of patients with coronary heart disease was not significantly correlated with serum total cholesterol, triglyceride, high density lipoprotein and low density lipoprotein P> 0.05). Conclusion: The decrease of CD4 + Foxp3 + Treg and the increase of TNF-α may be involved in the development of acute coronary syndrome.