急性冠状动脉综合征患者外周血Th3细胞的水平及意义

目的：研究急性冠状动脉综合征（ACS）患者Th3细胞与斑块不稳定和急性冠脉动脉综合征的关系.方法：将91例患者分为4组：急性心肌梗死（AMI）组26例,不稳定型心绞痛（UA）组25例,稳定型心绞痛SA组22例和胸部疼痛综合征（CPS）组18例.采用流式细胞仪分析Th3细胞占CD4＋T细胞的比例.应用酶联免疫吸附方法（ELISA）检测患者外周血血浆Th3相关细胞因子的表达.结果：与SA组和CPS组患者相比,ACS患者外周血Th3数量和TGF-1β1水平显著降低（P〈0.01）.AMI组患者（2.7±1.1）%及UA（2.5±0.9）%Th3细胞（CD4＋TGF-1β1＋/CD4＋T细胞）比例明显低于SA组（4.94±1.7）%和CPS组（4.5±1.8）%,（P〈0.01）,而SA组和CPS组无明显差异（P〉0.05）.AMI组（4.84±2.64μg/L）及UA组（4.39±2.38μg/L）的TGF-1β1的浓度均显著低于SA组（7.40±4.22μg/L）和CPS组（6.57±3.76μg/L）.结论：Th3细胞下调可能参与动脉粥样斑块不稳定和急性冠状动脉综合征的发病.

Significance of the alteration of Th3 in patients with acute coronary syndrome

AIM：To investigate the alteration and its significance of T help 3 cells（Th3） in patients with acute coronary syndrome.METHODS：Ninty-one patients were divided into 4 groups：acute myocardial infarction（AMI,n=26）,unstable angina（UA,n=25）,stable angina（SA,n=22） and chest pain syndrome（CPS,n= 18）.The frequencies of Th3 in peripheral blood were detected by flow cytometric analysis.Th3-related plasma cytokine（TGF-β1） concentrations were measured by enzyme-linked immunosorbent assay（ELISA）.RESULTS：The peripheral Th3 number and the levels of TGF-β1 were found to significant lower in patients with ACS as compared with those in patients with stable angina and chest pain syndrome（P〈0.01）.The frequencies of Th3（CD4＋TGF-β＋/CD4＋T cells） were markedly decreased in patients with AMI（2.7±1.1）% and UA（2.5±0.9）% than those in patients with SA（4.94±1.7）% and CPS（4.5±1.8）%（P〈0.01）,while there was no obvious difference between the SA group and the CPS group（P〉0.05）.Th3 related cytokine TGF-β1 markedly decreased in patients with AMITGF-β1：（4.84±2.64）μg/L] and UATGF-β1：（4.39±2.38）μg/L] compared with patients with SATGF-β1：（7.40±4.22）μg/L] and CPS TGF-β1：（6.57±3.76）μg/L].Plasma concentration of TGF-β1 was positively correlated in 4 groups（r=0.519,P〈0.01）.CONCLUSION：The downregulation of Th3 cells in patients with acute coronary syndrome may play a potential role in plaque destabilization and the onset of ACS.