慢性炎症及T淋巴细胞活性及心绞痛相关探究.docVIP

慢性炎症及T淋巴细胞活性及心绞痛相关探究 　作者：陈冰雪 刘莉 陈盛鹏 窦静 【摘要】 目的 测定冠心病心绞痛患者外周静脉血中白细胞介素18（IL18）、C反应蛋白（CRP）浓度及外周血辅助性T淋巴细胞（Th）功能的改变，观察心绞痛与非感染性炎症及细胞免疫功能之间的关系。方法 应用酶联免疫吸附法（ELISA）测定外周血清IL18浓度,速率散射比浊法测量CRP浓度；采用流式细胞分析法检测外周血CD4+细胞内干扰素γ（IFNγ）和白细胞介素4（IL4）的表达。同时分离外周血单个核细胞，经植物血凝素刺激培养后，应用ELISA检测培养上清液中IFNγ和IL4水平以测定辅助性T淋巴细胞的功能改变。结果 与对照组比较，心绞痛组患者炎性因子（IL18和CRP浓度）和辅助性T淋巴细胞因子（IFNγ）水平以及IFNγ/IL4比值明显高于对照组；IFNγ染色阳性的细胞占CD4+ T细胞的比率为15.34%，明显高于对照组的12.09%。而两组间IL4水平及IL4染色阳性细胞比率在两组间未见显著统计学差异。在心绞痛分组中，不稳定型心绞痛(UAP)组的IL18、CRP、IFNγ水平以及IFNγ/IL4比值明显高于稳定型心绞痛(SAP)组。结论 IL18、CRP、IFNγ浓度随冠状动脉病变的程度而升高，且与动脉粥样硬化斑块的稳定性有关。提示炎性因子和辅助性T淋巴细胞功能的失调可能参与了心绞痛患者冠脉粥样硬化斑块形成的过程。IL18与CRP、IFNγ浓度可能对冠心病心绞痛患者的诊断及预后有重要参考价值 【关键词】 白细胞介素；C反应蛋白；干扰素γ；T淋巴细胞；心绞痛 　　【Abstract】 Objective To measure the concentration of interleukin18（IL18），Creactive protein（CRP）and cellmediated immunity function in patients with coronary heart disease and angina pectoris and evaluate their clinical correlation. Methods IL18 was measured with ELISA,and serum CRP with rate scatter nephelometry,cytokineproducing CD4+ T cells with 3color flow cytometry. The levels of interferongamma (IFNγ) and IL4 in culture supernatants were measured with ELISA. Results The concentrations of IL18，CRP，IFNγ and ratio of IFNγ/IL4 in patients with angina pectoris were much higher than those in control.The frequencies of IFNγproducing T cells were found to be significantly higher in angina pectoris group(15.34%) than those in control(12.09%), while there was no significant difference on the frequencies of IL4producing peripheral Tlymphocytes between the two groups. In angina pectoris group, the concentrations of IL18，CRP，IFNγ and ratio of IFNγ/IL4 in unstable angina pectoris were much higher than those in stable angina pectoris. Conclusion The concentrations of IL18,CRP,IFNγ were increased with coronary arteriosclerosis and related to the stability of atherosclerotic plaques, suggesting that inflammation factor and imbalance of cellmediated immunity