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目的:探讨ST段抬高型急型心肌梗死(acute myocardial infarction,AMI)患者外周血中树突状细胞(dendritic cells,DCs)及其亚型的变化。方法:选择17例ST段抬高型AMI患者(AMI组)和14例稳定型心绞痛(stable angina pectoris,SAP)患者(SAP组)为研究对象,并以15例性别、年龄相匹配的冠状动脉造影阴性者为对照组。采用流式细胞技术三色分析法测定3组人群外周血中DCs及其亚型占外周血单个核细胞的百分比和绝对数,其中DCs以Lin1-HLA-DR+确定,髓样树突细胞(myeloid dendritic cell,mDC)以Lin1-HLA-DR+CD11c+确定,浆细胞样树突状细胞(plasmacytoid dendritic cell,pDC)以Lin1-HLA-DR+CD123+确定;并采用酶联免疫吸附试验法检测3组人群外周血中白细胞介素6(interleukin-6,IL-6)和肿瘤坏死因子(tumor necrosis factor-α,TNF-α)水平。其中ST段抬高型AMI患者在AMI发作7 d后进行随访。结果:AMI组患者急性期(<24 h)DCs占外周血单个核细胞的百分比、DCs的绝对数、mDC和pDC占外周血单个核细胞的百分比、mDC和pDC的绝对数、mDC与pDC比值均低于SAP组和对照组(P<0.01、0.05)。发作7 d后复查,AMI组DCs占外周血单个核细胞的百分比、DCs的绝对数、mDC和pDC占外周血单个核细胞的百分比、mDC和pDC的绝对数、mDC与pDC比值均高于急性期(P<0.01、0.05)。SAP组与对照组外周血中DCs占外周血单个核细胞的百分比、DCs的绝对数、mDC和pDC占外周血单个核细胞的百分比、mDC和pDC的绝对数、mDC与pDC比值差异均无统计学意义(P>0.05)。AMI患者急性期血清TNF-α及IL-6水平高于对照组和SAP组(P<0.05),发作7 d后IL-6水平明显降低(P<0.05)。结论:AMI时外周血中的DCs包括mDC及pDC在急性期均明显降低,发作7 d后恢复至正常水平,提示外周血中DCs在AMI急性期可能参与了不稳定斑块的形成。
Objective: To investigate the changes of dendritic cells (DCs) and their subtypes in peripheral blood of ST-elevation acute myocardial infarction (AMI) patients. Methods: Seventeen ST-segment elevation AMI patients (AMI group) and 14 stable angina pectoris (SAP) patients (SAP group) were enrolled in this study. Fifteen patients with gender-related age-matched coronary artery Contrast negative as a control group. The percentages and absolute numbers of peripheral blood mononuclear cells (DCs) and their subtypes in peripheral blood were determined by flow cytometry tricolor analysis. The DCs were determined by Lin1-HLA-DR +, myeloid dendritic cell (mDC) was determined by Lin1-HLA-DR + CD11c +, and plasmacytoid dendritic cells (pDC) were determined by Lin1-HLA-DR + CD123 +. ELISA and enzyme-linked immunosorbent assay The level of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in peripheral blood of the population. ST-segment elevation AMI patients were followed up for 7 days after AMI. Results: The percentage of DCs in peripheral blood mononuclear cells, the absolute number of DCs, the percentage of mDC and pDC in peripheral blood mononuclear cells, the absolute numbers of mDC and pDC, the ratio of mDC to pDC in acute phase (<24 h) Were lower than SAP group and control group (P <0.01,0.05). In the AMI group, the percentage of DCs in peripheral blood mononuclear cells, the absolute number of DCs, the percentage of mDC and pDC in peripheral blood mononuclear cells, the absolute numbers of mDC and pDC, the ratio of mDC to pDC were all higher than those in acute (P <0.01, 0.05). The percentage of peripheral blood mononuclear cells, the absolute number of DCs, the percentage of mDC and pDC in peripheral blood mononuclear cells, the absolute numbers of mDC and pDC, the ratio of mDC to pDC in SAP group and control group Significance (P> 0.05). The serum levels of TNF-α and IL-6 in patients with acute myocardial infarction (AMI) were significantly higher than those in control and SAP groups (P <0.05). CONCLUSIONS: DCs, including mDC and pDC, in peripheral blood of AMI patients were significantly decreased in acute phase and returned to normal levels in 7 days after AMI, suggesting that peripheral blood DCs may be involved in the formation of unstable plaques during acute AMI.