摘要
目的研究外周血辅助性T细胞17(Th17)/调节性T细胞(Treg)平衡与冠状动脉旁路移植术后心房颤动发生的关系。方法选取2015年1月至2017年12月于郑州市第七人民医院接受冠状动脉旁路移植术治疗的患者200例为研究对象,根据术后是否发生心房颤动分为心房颤动组46例与非心房颤动组154例。比较两组患者一般资料,外周血Th17、Treg细胞比例、Th17/Treg水平,外周血Th17、Treg相关细胞因子变化情况。并应用多因素Logistic回归分析分析冠状动脉旁路移植术后心房颤动发生的危险因素。结果心房颤动组性别、年龄、体质指数(BMI)、脑卒中、心肌梗死、高脂血症、糖尿病、高血压及肾功能不全情况与非心房颤动组对比差异均无统计学意义(P>0.05)。心房颤动组外周血Th17细胞比例以及Th17/Treg水平均高于非心房颤动组(P<0.05),两组Treg细胞比例比较差异无统计学意义(P>0.05)。心房颤动组外周血白细胞介素-6(IL-6)、白细胞介素-17(IL-17)水平均高于非心房颤动组(P<0.05),两组白细胞介素-10(IL-10)、转化生长因子-β(TGF-β)水平比较无统计学意义(P>0.05)。经多因素Logistic回归分析:Th17/Treg、IL-6、IL-17均是影响冠状动脉旁路移植术后心房颤动发生的独立危险因素(P<0.05)。结论冠状动脉旁路移植术后心房颤动患者存在明显的Th17/Treg细胞平衡紊乱,临床工作中可能通过调节Th17/Treg细胞平衡,从而达到降低冠状动脉旁路移植术后心房颤动发生的风险。
Objective To study the relationship between peripheral blood Th17/Treg balance and atrial fibrillation(AF)after coronary artery bypass grafting(CABG).Methods The patients(n=200)received CABG were chosen from the Seventh People's Hospital of Zhengzhou City from Jan.2015 to Dec.2017,and divided,according to whether or not they had AF after CABG,into AF group(n=46)and non-AF group(n=154).The general data,proportions of Th17 and Treg in peripheral blood,level of Th17/Treg and changes of cytokines related to Th17 and Treg were compared between 2 groups.The risk factors of AF occurrence after CABG were analyzed by using multi-factor Logistic regression analysis.Results The difference in sex,age,BMI,stroke,myocardial infarction,hyperlipidemia,diabetes,hypertension and renal insufficiency had no statistical significance between 2 groups(P >0.05).The proportion of Th17 and level of Th17/Treg in peripheral blood were higher in AF group than those in non-AF group(P<0.05),and proportion of Treg had no statistical difference between 2 groups(P >0.05).The levels of IL-6 and IL-17 were higher in AF group than those in non0AF group(P<0.05),and IL-10 and TGF-βhad no statistical difference between 2 groups(P >0.05).The results of multi-factor Logistic regression analysis showed that Th17/Treg,IL-6 and IL-17 were independent risk factors influencing on AF occurrence after CABG(P<0.05).Conclusion AF patients have disorders of Th17/Treg balance after CABG.The risk of AF after CABG may be reduced through regulating Th17/Treg balance in clinical practice.
作者
刘春明
王正飞
杨龙
兰占占
Liu Chunming;Wang Zhengfei;Yang Long;Lan Zhanzhan(Department of Cardiac Surgery,Seventh People's Hospital of Zhengzhou City,Zhengzhou 450016,China)
出处
《中国循证心血管医学杂志》
2019年第1期71-74,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
河南省郑州市科技发展计划项目(20140547)
