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目的 研究老年急性冠状动脉综合征 (ACS)患者树突状细胞 (DC)的功能。方法 将 4 5例ACS患者分为老年组 (2 5例 )和非老年组 (2 0例 ) ,另选健康体检者 2 2例分为老年对照组 (12例 )和非老年对照组 (10例 ) ,入院时取外周血分离单个核细胞 ,制备DC。检测DC表面共刺激分子CD86的表达和DC对同种异体T淋巴细胞的刺激能力 ;酶联免疫吸附法测定培养液中细胞因子浓度 ;分析CD86表达相关因素。结果 与非老年组比较 ,老年组DC功能下降。与老年和非老年对照组比较 ,ACS患者DC表面CD86的表达明显增高 ;对T淋巴细胞刺激的能力增强 ;经DC刺激的淋巴细胞分泌致炎细胞因子增多 ,抑炎细胞因子减少 ;CD86的表达与血清低密度脂蛋白及C反应蛋白水平呈正相关。ACS时DC的激活与年龄无关。结论 正常人DC功能随年龄增加而下降 ;老年ACS患者DC的功能亢进可能是ACS发病及预后不良的原因 ;低密度脂蛋白与DC的激活有关。
Objective To investigate the function of dendritic cells (DCs) in elderly patients with acute coronary syndrome (ACS). Methods Forty-five ACS patients were divided into the elderly group (25 cases) and the non-elderly group (20 cases), and the other 22 cases were divided into the elderly control group (12 cases) and the non-elderly control group Cases), admission to take peripheral blood mononuclear cells isolated, preparation of DC. The expression of costimulatory molecule CD86 on DC surface and the stimulation ability of DC on allogeneic T lymphocytes were detected. The concentration of cytokines in culture medium was determined by enzyme-linked immunosorbent assay. The related factors of CD86 expression were analyzed. Results Compared with the non-elderly group, the DC function of the elderly group decreased. Compared with the elderly and non-elderly control group, the expression of CD86 on the surface of DC in patients with ACS was significantly increased; the ability to stimulate T lymphocytes was enhanced; the number of pro-inflammatory cytokines secreted by DCs stimulated by DC increased; the expression of CD86 decreased And serum low density lipoprotein and C-reactive protein levels were positively correlated. The activation of DC at ACS has nothing to do with age. Conclusions The function of DC in normal subjects declines with increasing age. The hyperthyroidism of DC in elderly patients with ACS may be the reason of the poor prognosis of ACS. Low density lipoprotein is associated with the activation of DC.