静脉血栓栓塞症与冠状动脉粥样硬化患者T细胞免疫功能变化的比较分析

周琳; 王乐民; 蒋金法; 徐文俊; 许嘉鸿; 宋浩明

doi:10.13201/j.issn.1001-1439.2015.05.016

静脉血栓栓塞症与冠状动脉粥样硬化患者T细胞免疫功能变化的比较分析

- 同济大学附属同济医院心内科(上海, 200065)
基金项目:
上海市卫生局课题(No:2010108)

上海市科委重点项目课题(No:11411951400)

上海市卫生局青年课题(No:2009Y071)

详细信息

作者简介:
宋浩明,E-mail:songhao-ming@163.com

中图分类号: R543.5

收稿日期: 2014-07-13

Comparison of immune function of T cells in patients with venous thromboembolism or coronary artery atherosclerosis

- Department of Cardiology, Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065, China

Received Date: 13 July 2014

摘要

摘要: 目的:研究静脉血栓栓塞症(VTE)患者、冠心病(CHD)患者与正常对照组之间T淋巴细胞亚群(CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺)水平变化以及超敏C-反应蛋白(high-sensitivity C-reactive protein,hs-CRP)的差异。方法:入选247名研究对象,其中正常对照组82例,VTE组51例,CHD组114例。分别检测T淋巴细胞亚群(CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺)、hs-CRP、空腹血糖(FBG)以及血脂系列。结果:VTE组与对照组相比,CD3⁺T淋巴细胞显著降低(P<0.05),CD4⁺T淋巴细胞没有显著性差异(P>0.05),CD8⁺T淋巴细胞显著降低(P<0.01),CD4/CD8比例升高(P<0.05)。CHD组与对照组相比,CD8⁺T显著降低(P<0.01),CD4/CD8升高(P<0.05)。VTE组与CHD组相比CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺无显著性差异。观察3组间CD值过低、正常及过高各占比例,并行χ²值检验,结果发现VTE组、CHD组与对照组相比有统计学意义,主要表现在CD3⁺和CD8⁺T淋巴细胞下降的比例升高;CD4⁺/CD8⁺升高的比例显著增多,而CHD组与VTE组没有明显区别。VTE组和CHD组hs-CRP均高于对照组,而VTE组和CHD组间差异没有统计学意义。结论:VTE组与CHD组均存在T淋巴细胞免疫功能紊乱,表现为CD3⁺和CD8⁺T淋巴细胞减少,CD4⁺T淋巴细胞没有明显变化,CD4/CD8比值显著升高。提示VTE和CHD患者整体的T细胞识别抗原和转导活化信号的功能下降,同时T细胞直接杀伤病毒微生物的功能显著下降。同时炎性因子hs-CRP在VTE组及CHD组均明显升高,提示相同的炎症免疫机制参与了静脉血栓与动脉血栓的发生发展。
- 免疫功能 /
- T淋巴细胞 /
- 静脉血栓栓塞症 /
- 冠状动脉粥样硬化
Abstract: Objective:Recent studies showed the major risk factors of arterial thrombotic diseases were closely related to venous thrombosis.This study aimed to investigate the expressions of CD3,CD4 and CD8in T lymphocytes,CD4/CD8 ratio and high-sensitivity C-reactive protein(hs-CRP) in patients with VTE,coronary artery atherosclerosis(CAA) and healthy subjects.Method:A total of 82 healthy subjects,51 VTE patients and 114 CAA patients were recruited,and the expressions of CD3,CD4 and CD8in T lymphocytes and CD4/CD8 ratio were determined.The serum hs-CRP was also measured.Result:When compared with healthy subjects,VTE patients had significantly reduced CD3expression(P<0.05),comparable CD4expression(P>0.05),significantly reduced CD8(P<0.01) and increased CD4/CD8ratio(P<0.05).CHD patients had significantly reduced CD8(P<0.01) and increased CD4/CD8ratio(P<0.05).However,VTE patients had comparable expressions of CD3,CD4 and CD8 and CD4/CD8 ratio to CAA patients.In addition,results showed,among patients with VTE or CAA,the proportion of patients with reduced CD3⁺ and CD8⁺T lymphocytes or increased CD4⁺/CD8⁺ratio increased significantly when compared with healthy subjects.In addition,hs-CRP in VTE group and CAA group was significantly higher than that in healthy subjects.Conclusion:The antigen recognition and signal transduction activation of T cells reduce significantly in patients with VTE or CAA,and the killing effect of T cells on pathogens including virus is also significantly compromised.In addition,inflammatory and immune mechanisms are involved the occurrence and development of venous and arterial thrombosis.
- immune function /
- T cell /
- venous thromboembolism /
- coronary atherosclerosis

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