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目的:探讨阿托伐他汀对不稳定型心绞痛(UA)患者外周血辅助性T淋巴(T help,Th)细胞亚群的影响及意义。方法:采用流式细胞分析法检测38例UA患者,28例稳定型心绞痛(SA)患者及20例胸痛综合征(CPS)患者外周血CD4+细胞内细胞因子干扰素γ(IFN-γ)和白细胞介素4(IL-4)的表达;分离患者外周血单个核细胞,与不同浓度阿托伐他汀(0、0.3、1和3μmol/L)共培养,观察Th细胞亚群的变化。结果:UA患者发病24h内Th1细胞比例(20.73%±4.87%)明显高于SA组(9.8%±3.29%)和CPS组(6.65%±1.89%),Th2细胞比例无显著性差异。与阿托伐他汀共培养后,Th1细胞比例明显下降(20.73%、16.03%、14.75%和10.2%),IL-4表达无明显变化。结论:UA患者存在T细胞亚群平衡偏移,主要表现为Th1细胞功能亢进,可能是其发病机制之一;阿托伐他汀可能通过影响Th细胞亚群极化状态降低UA的发病。
Objective: To investigate the effect and significance of atorvastatin on T helper (Th) cell subsets in peripheral blood of patients with unstable angina pectoris (UA). Methods: Flow cytometry was used to detect the levels of CD4 (superscript +) and cytokines (IFN-γ) and leucocytes in 38 patients with UA, 28 patients with stable angina pectoris (SA) and 20 patients with chest pain syndrome (CPS) The expression of IL-4 was detected. Peripheral blood mononuclear cells were isolated and cocultured with different concentrations of atorvastatin (0, 0.3, 1 and 3 μmol / L) to observe the changes of Th cell subsets. Results: The proportion of Th1 cells in UA patients was significantly higher than that in SA patients (9.8% ± 3.29%) and CPS patients (6.6% ± 1.89%) for 24 hours of onset of onset. The proportion of Th2 cells in UA patients was not significantly different. After co-cultured with atorvastatin, the proportion of Th1 cells was significantly decreased (20.73%, 16.03%, 14.75% and 10.2%), while IL-4 expression did not change significantly. CONCLUSIONS: The imbalance of T cell subsets exists in UA patients, which is mainly due to the hyperactivity of Th1 cells, which may be one of the pathogenesis of UA. Atorvastatin may reduce the incidence of UA by influencing the polarization status of Th cells.