慢性心力衰竭患者外周血Th17/Treg失衡的研究及意义

目的探讨慢性心力衰竭(CHF)患者外周血中Th17细胞、CD4+CD25+CD127-调节性T细胞(Treg)的变化及意义。方法 53例CHF患者按照NYHA心功能分级分为CHF1组(NYHA心功能Ⅰ~Ⅱ级,n=24)和CHF2组(NYHA心功能Ⅲ~Ⅳ级,n=29)。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。结果 CHF1组和CHF2组患者外周血中Th17/CD4+T细胞的比例明显高于对照组(1.89±1.24 vs 0.51±0.35,3.35±1.78 vs 0.51±0.35;P<0.05;P<0.01),CHF2组亦明显高于CHF1组(3.35±1.78 vs 1.89±1.24,P<0.01);CHF1组和CHF2组患者外周血中Treg/CD4+T细胞的比例明显低于对照组(5.69±0.74 vs 7.89±1.66,3.31±0.98 vs 7.89±1.66;P<0.01;P<0.01),CHF2组亦明显低于CHF1组(3.31±0.98 vs 5.69±0.74,P<0.01);CHF1组和CHF2组患者Th17/Treg的比值明显高于对照组(0.35±0.17 vs 0.11±0.09,1.06±0.49 vs 0.11±0.09;P<0.05;P<0.01),CHF2组亦明显高于CHF1组(1.06±0.49 vs 0.35±0.17,P<0.01)。结论 CHF患者外周血中存在Th17/Treg失衡,且与心功能有一定关系,Th17/Treg失衡可能参与了CHF的发生发展。

The imbalance between Th17 and regulatory T cells in patients with chronic heart failure

Objective To explore the significance of the imbalance between Thl7 and CD4＋ CD25＋ CD127-regulatory T cells（Treg）in patients with chronic heart failure（CHF）.Methods Peripheral blood were collected from 53 patients with CHF or 20 healthy controls.The 53 patients were divided into the CHF1 group（NYHAⅠ-Ⅱ,n=24）or CHF2 group（NYHA Ⅲ-Ⅳ,n=29）,according to NYHA heart function class.The proportion of Thl7 and CD4＋ CD25＋ CD127-Treg was detected by flow cytometry.Results The proportion of Thl7 cells was significantly higher in the patients of CHF1 and CHF2 group than that in healthy control（1.89±1.24 vs 0.51±0.35,3.35±1.78 vs 0.51±0.35;P〈0.05;P〈0.01）,The proportion of Thl7 cells was significantly higher in patients with CHF2 group than that in patients with CHF1 group（3.35±1.78 vs 1.89±1.24,P〈0.01）;The proportion of CD4＋ CD25＋ CD127-Treg was significantly lower in patients with CHF1 group and CHF2 group than that in healthy controls（5.69±0.74 vs 7.89±1.66,P〈0.01;3.31±0.98 vs 7.89±1.66,P〈0.01）.The proportion of CD4＋ CD25＋ CD127-Treg was significantly lower in the patients of CHF2 group than that in CHF1 group（3.31±0.98 vs 5.69±0.74,P〈0.01）.The ratio of Th17/Treg was significantly higher in patients with CHF1 group and CHF2 group than that in healthy control（0.35±0.17 vs 0.11±0.09,P0.05;1.06±0.49 vs 0.11±0.09,P〈0.01）.and it was confirmed that the ratio of Th17/Treg was significantly higher in patients with CHF2 group than that in patients with CHF1 group（1.06±0.49 vs 0.35±0.17,P〈0.01）.Conclusion Th17/Treg imbalance exists in patients with CHF,and it may play a potential role in the onset and development of CHF.