老年急性冠状动脉综合征患者树突状细胞的功能状态

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。

Function of dendritic cells in old patients with acute coronary syndrome

Objective To investigate the function of dendritic cells(DC) in old patients with acute coronary syndrome(ACS).Methods PBMCs from 45 patients(25 old and 20 non-old) with ACS and 22 healthy subjects(10 old and 12 non-old) were incubated and induced to mature DC.The flow cytometric analysis was used to detect the expression of co-stimulating factor CD86 on DC. The stimulating capacity of DC in allogenic mixed lymphocyte reaction (MLR)was determined.ELISA was used to analyze the level of cytokines in the medium of MLR. Relationship of CD86 expression to risk factors and blood C-reactive protein(CRP) level was also analyzed.Results In the normal control group, DC function was reduced in the elderly as compared with the younger. When compared with normal group,much more CD86 was expressed on DC in ACS,the stimulating capacity of DC in MLR was higher and T lymphocytes in MLR secreted higher levels of pro-inflammation cytokines.These were age-independent. In ACS, CD86 expression correlated with hsCRP and LDL significantly.Conclusions DCs in the elderly are inhibited.In ACS, DCs are activated,which may play an important role in initiating the inflammatory reaction in the event,and their marked change may be one of the causes of poor prognosis in old ACS.LDL may be one of the activators of DC.