先天性心脏病患者免疫因子Th17/Treg失衡与肺动脉高压的关系

目的:探讨患者外周血中Th17细胞、CD4+D25+FoxP3+调节性T细胞(Treg)的变化及意义。方法:75例先天性心脏病(CHD)合并肺动脉高压(PAH)患者,分为轻度肺动脉高压组(28例)、中度肺动脉高压组(32例)及重度肺动脉高压组(15例),20例健康体检者作为对照组。采用流式细胞分析法检测外周血中Th17细胞、Treg细胞占CD4+T细胞的比例,分析Th17细胞与Treg细胞的比例与肺动脉压的相关性。结果:Th17/CD4+T细胞比例、Treg/CD4+T细胞的比例和Th17/Treg细胞比值,两组间差异具有统计学意义(P<0.05),随着肺mPAP的增加,Th17/CD4+T细胞比例明显升高;Treg/CD4+T细胞的比例明显下降;Th17/Treg细胞比值显著升高。mPAP与Th17/Treg比值呈显著正相关(r=0.95,P<0.05)。结论:先天性心脏病合并肺动脉高压患者外周血中存在Th17/Treg失衡,且与肺动脉高压程度呈正相关,Th17/Treg失衡可能参与了肺动脉高压的发生发展。

The imbalance between Th17 and regulatory T cells in congenital heart disease with pulmonary hypertension

Objective:To explore the significance of the imbalance between Thl7 and CD4+D25+FoxP3+ regulatory T cells(Treg) in congenital heart disease(CHD)with pulmonary artery hypertension(PAH).Methods: Peripheral blood were collected from 75 patients with pulmonary artery complicated by CHD hypertension and 20 cases of healthy subjects served as control group.The 75 patients were divided into were divided three groups according to mean pulmonary arterial pressure(mPAP) by right heart catheterization: mild-PH group(n=28);moderate-PH group(n=32) andsevere-PH group(n=15),The proportion of Thl7and Treg was detected by flow cytometry.Results:With the increase of mPAP,Th17/CD4 + T cell ratio have a significantly increased;proportion of Treg/CD4 + T cells markedly decreased;Th17/CD4 + T cells ratio,Treg/CD4 + T cell ratio and the ratio of the Th17 / Treg cells among different groups have significant differences(P<0.05).mPAP and Th17/Treg ratio showed a significant positive correlation(r=0.95,P <0.05).Conclusion: Th17 / Treg imbalance exists in patients with PAH by CHD hypertension,and it may play a potential role in the onset and development of PH.