摘要
目的探讨先天性心脏病相关性肺动脉高压(pulmonary arterial hypertension associated with congenital heart disease,CHD-PAH)患者外周血中1型辅助性T细胞(Th1)、2型辅助性T细胞(Th2)、17型辅助性T细胞(Th17)和调节性T(Treg)细胞表达水平变化及其临床意义。方法选取昆明医科大学附属延安医院心血管内科2017年5月至2019年12月收治的先天性心脏病患者69例,根据肺动脉平均压(mean pulmonary artery pressure,mPAP)值将其分为3组:正常组(B组,27例),轻度组(C组,20例)和中重度组(D组,22例),同时选取健康成人对照组(A组,14例)。收集患者外周血,通过流式细胞术检测外周血中Th1、Th2、Th17、Treg细胞的表达水平,计算Th1/Th2、Th17/Treg值,并分析各细胞表达水平与mPAP的相关性。结果与A组相比,CHD各组患者血清的Th1、Th17水平、Th1/Th2比值均呈升高趋势,Th2、Treg水平呈降低趋势,差异无统计学意义(P>0.05);与A组相比,B组、C组、D组的Th17/Treg比值升高,差异有统计学意义[0.13(0.07,0.45)比1.68(0.15,4.02)比1.51(0.18,4.19)比1.39(0.19,2.47),P<0.05];与A组相比,B组患者的Treg细胞水平降低,差异有统计学意义(P<0.05);与B组相比,C组Th1、Th2水平、Th17/Treg值呈下降趋势,Th17、Treg水平、Th1/Th2值呈上升趋势,差异无统计学意义(P>0.05),D组的Th1、Th2、Th17、Treg水平、Th1/Th2值均呈升高趋势,Th17/Treg值呈下降趋势,差异无统计学意义(P>0.05);与C组相比,D组的Th1、Th2、Th17水平、Th1/Th2值呈上升趋势,Treg水平、Th17/Treg比值呈下降趋势,差异无统计学意义(P>0.05);B组、C组、D组患者的Th17细胞的表达水平与mPAP呈正相关(R=0.272,P<0.05)。结论CHD-PAH患者外周血中存在Th17/Treg失衡,Th17/Treg失衡可能在CHD-PAH的发生发展中起着重要的作用。
Objective To explore the changes of the expression levels of T helper cell 1(Th1),T helper cell 2(Th2),T helper cell 17(Th17),and Treg cells in peripheral blood of patients with pulmonary hypertension associated with congenital heart disease(CHD-PAH)and their clinical significance.Methods A total of 69 patients with congenital heart disease admitted to the Department of Cardiology,Yan’an Affiliated Hospital of Kunming Medical University,from May 2017 to December 2019 were selected.Based on the mean pulmonary artery pressure(mPAP)values,they were divided into three groups:nonpulmonary hypertension group(group B,27 cases),mild pulmonary hypertension group(group C,20 cases),and moderate-severe pulmonary hypertension group(group D,22 cases).Meanwhile,a control group of 14 healthy adults(group A)was selected.Peripheral blood samples were collected from patients,and flow cytometry was used to detect the expression levels of Th1,Th2,Th17,and Treg cells in peripheral blood.The Th1/Th2 and Th17/Treg ratios were calculated,and the correlation between cell expression levels and mPAP was analyzed.Results Compared with the group A,the levels of Th1,Th17,and the Th1/Th2 ratio in the serum of CHD patients showed an increasing trend,while the levels of Th2 and Treg showed a decreasing trend,but the differences were not statistically significant(P>0.05).Compared with Group A,the Th17/Treg ratio in group B,group C and group D were higher,and the difference was statistically significant[0.13(0.07,0.45)vs.1.68(0.15,4.02)vs.1.51(0.18,4.19)vs.1.39(0.19,2.47),P<0.05].Compared with group A,the level of Treg in group B was significantly decreased(P<0.05).Compared with the group B,the group C showed a decreasing trend in Th1,Th2 levels,and Th17/Treg ratio,and an increasing trend in Th17,Treg levels,and Th1/Th2 ratio,but the differences were not statistically significant(P>0.05).The levels of Th1,Th2,Th17,Treg,and Th1/Th2 ratio in group D showed an increasing trend,while the Th17/Treg ratio showed a decreasing trend,but the differences w
作者
缪美琪
尹小龙
光雪峰
戴海龙
MIAO Mei-qi;YIN Xiao-long;GUANG Xue-feng;DAI Hai-long(Department of Cardiology,Yan’an Affiliated Hospital of Kunming Medical University,Kunming 650051,China)
出处
《中国心血管病研究》
CAS
2023年第12期1057-1063,共7页
Chinese Journal of Cardiovascular Research
基金
国家自然科学基金(82060018、81700438)
云南省自然科学基金(202301AY070001-300、202101AS070043、202102AA310003-7、202105AF150019)。
