不同心功能患者T淋巴细胞亚群的变化

目的研究不同心功能分级患者外周血T淋巴细胞亚群的变化。方法健康体检者39例为对照组,器质性心脏病患者84例,根据心功能分级标准(NYHA),心功能Ⅰ级组33例,Ⅱ级组20例、Ⅲ级组16例、Ⅳ级组15例。采用流式细胞仪测定外周血T淋巴细胞亚群CD3、CD4、CD8,计算CD4/CD8比值,超声心动图测定左心室射血分数(LVEF)。结果T淋巴细胞亚群CD3水平在对照组和心功能Ⅰ、Ⅱ、Ⅲ、Ⅳ级组之间差异无显著性;CD4水平从心功能Ⅰ级至Ⅳ级组逐渐降低,对照组及心功能Ⅰ级组与心功能Ⅲ级组、Ⅳ级组比较,差异均有显著性(P<0.01),心功能Ⅱ级组与Ⅳ级组比较差异也有显著性(P<0.05);CD8水平在心功能Ⅳ级组明显升高;CD4/CD8与CD4变化相一致,随心功能减退而降低。结论心力衰竭患者存在细胞免疫功能异常,随心功能减退辅助性T淋巴细胞数量减少,提示调节细胞免疫治疗可能会使心力衰竭患者获益。

Changes of T lymphocyte subsets in patients with different cardiac functions

Objective To Study the changes of T lymphocyte subsets in patients with different cardiac dysfunctions.Methods Thirty-nine normal controls and 84 patients with heart diseases were analyzed.According to NYHA standard,84 patients were divided into 33 cases of grade 1,20 cases of grade 2,16 cases of grade 3 and 15 cases of grade 4.Flow cytometry was applied for assessing proportions of CD_3 T cells,CD_4 T cells and CD_8 T cells and CD_4/CD_8 ratio.Echocardiography was used to measure the ejection fraction of left ventricle(LVEF).Results The levels of CD_3 T cells were not significantly different between normal controls and different cardiac dysfunction groups.The levels of CD_4 T cells gradually decreased from cardiac dysfunction of grade-1 group to grade-4 group,and there were significant differences between normal control group,cardiac dysfunction of grade-1 group,grade-3 group and grade-4 group(P<0.01).The change of CD_4/CD_8 ratio was same as that of CD_4 T cells and decreased with increasing cardiac dysfunction.Conclusions There is abnormal cell immune function and the number of helper T cells is reduced in patients with heart failure.The results show that the treatment with regulating cell immune function may be beneficial to patients with heart failure.