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目的:探讨外周血CD4+T细胞、CD8+T细胞、CD4+CD25+调节性T细胞、自然杀伤细胞(NK细胞)水平与冠状动脉(冠脉)病变程度的关系。方法:选择收治的冠心病或疑诊为冠心病行冠脉造影的患者126例,按临床表现,冠脉造影诊断分为4组:急性心肌梗死(AMI)组34例、不稳定型心绞痛(UAP)组49例、稳定型心绞痛(SAP)组20例和冠脉造影正常胸痛综合征组(对照组)23例,采用流式细胞术测定4组患者外周血CD4+T细胞、CD8+T细胞、CD4+CD25+调节性T细胞(分为CD4+CD25+T细胞和CD4+CD25++T细胞)、NK(CD3-CD16+CD56+)细胞亚群占淋巴细胞的比例。同时分析各组T细胞亚群和NK细胞水平与Gensini积分相关性。结果:AMI组和UAP组CD4+T细胞较对照组显著升高,而CD8+T细胞、CD4+CD25+调节性T细胞、NK细胞显著降低(P<0.05);SAP组较对照组NK细胞显著升高(P<0.05)。CD8+T细胞,CD4+CD25+T细胞,CD4+CD25++T细胞与Gensini积分均呈负相关性(P<0.05)。结论:CD4+升高,CD8+T细胞、CD4+CD25+调节性T细胞、NK细胞降低可能反映了冠心病患者异常增强的免疫反应及免疫调节受损,其参与了动脉粥样硬化的发生发展。随着免疫调节受损加重,冠脉病变的数量和狭窄程度可能加重。
Objective: To investigate the relationship between the levels of CD4 (superscript +) T cells, CD8 + T cells, CD4 + CD25 + regulatory T cells, natural killer cells (NK cells) and the degree of coronary artery (coronary artery) in peripheral blood. Methods: One hundred and sixty-six patients with coronary heart disease or suspected coronary artery disease undergoing coronary angiography were divided into 4 groups according to the clinical manifestations: 34 cases of acute myocardial infarction (AMI), unstable angina pectoris 49 cases of UAP group, 20 cases of stable angina pectoris (SAP) group and 23 cases of normal chest pain syndrome group (control group). Flow cytometry was used to detect the percentage of CD4 + T cells, CD8 + T CD4 + CD25 + regulatory T cells (divided into CD4 + CD25 + T cells and CD4 + CD25 + T cells), NK (CD3-CD16 + CD56 +) cell subsets accounted for the proportion of lymphocytes. At the same time, the correlation between T cell subsets and NK cells in each group and Gensini score was analyzed. Results: CD4 + T cells in AMI group and UAP group were significantly higher than those in control group, while CD8 + T cells, CD4 + CD25 + regulatory T cells and NK cells were significantly decreased (P <0.05); NK cells in SAP group were significantly higher than those in control group Increased (P <0.05). CD8 + T cells, CD4 + CD25 + T cells and CD4 + CD25 + T cells were negatively correlated with Gensini scores (P <0.05). Conclusion: The increased CD4 +, CD8 + T cells, CD4 + CD25 + regulatory T cells and NK cells may reflect abnormally enhanced immune response and impaired immune regulation in patients with coronary heart disease, which is involved in the development of atherosclerosis. As immunocompromised patients become worse, the number and severity of coronary lesions may worsen.