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目的 :探讨风湿性心脏病 (RHD)细胞免疫是否存在异常及其特点 ,为 RHD的早期免疫诊断及今后的免疫疗法提供依据。方法 :对 41例 RHD和 44例 RHD伴风湿活动 (RF)患者的 T淋巴细胞亚群、淋巴细胞转化率、自然杀伤 (NK)细胞数量及活性 ,HL A- DR抗原遗传位点进行了测定 ,并与正常对照组 (5 0例 )比较。结果 :RHD和 RF组细胞免疫功能活性增强 ,表现为 CD4数量增加 ,CD8数量减少 ,CD4/ CD8比值增大 ,与正常对照组比较 P <0 .0 5和 P <0 .0 1;RF组淋巴细胞转化率较正常对照组和 RHD组高 (P <0 .0 1) ,NK细胞数量增加 ,但活性降低 (P <0 .0 1和 P <0 .0 5 ) ;RF和 RHD组 HL A- DR4抗原呈高频分布 (5 3.6 %和 47.7% ) ,DR5 呈低频分布(14.6 %和 15 .9% ) (P <0 .0 1)。结论 :RHD存在细胞免疫功能异常 ,且发生自身免疫趋式 ,其机制可能是细胞免疫调控失衡。 DR4的高频分布 ,可作为 RHD早期诊断的危险度估计
Objective: To investigate the abnormalities and characteristics of cellular immunity in patients with rheumatic heart disease (RHD) and provide evidence for the early diagnosis of RHD and future immunotherapy. Methods: T lymphocyte subsets, lymphocyte transformation rate, number and activity of natural killer (NK) cells in 41 patients with rheumatoid arthritis (RHD) and 44 rheumatoid arthritis patients with rheumatoid arthritis (RHD) and the genetic locus of HLA-DR antigen were determined , And compared with the normal control group (50 cases). Results: The immune function of RHD and RF group was enhanced, the number of CD4 was increased, the number of CD8 was decreased and the ratio of CD4 / CD8 was increased. Compared with normal control group, P <0.05 and P <0.01; RF group The lymphocyte transformation rate was higher than that of the normal control group and the RHD group (P <0.01). The number of NK cells increased but the activity decreased (P <0.01 and P <0.05) A-DR4 antigen showed high frequency distribution (53.6% and 47.7%), DR5 showed low frequency distribution (14.6% and 15.9%) (P <0.01). CONCLUSION: RHD has abnormal cellular immunity and autoimmune tendency. Its mechanism may be imbalance of cellular immune regulation. DR4 high frequency distribution, can be used as an early diagnosis of RHD risk estimates