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目的:探讨急性冠状动脉综合征(ACS)患者外周血中单核细胞共刺激分子CD28、细胞毒T淋巴细胞抗原(CTLA)4、CD80(B7-1)的变化,探讨这些分子在发病中的意义。方法:采用直接荧光标记流式细胞仪测定23例ACS患者(ACS组)和31例稳定型心绞痛(SA)患者(SA组)入院时外周血CD4+,CD8+T淋巴细胞CD28、CTLA4、B7-1分子的表达,同时选健康人群15例作为对照(对照组)。结果:与对照组相比,SA组及ACS组发病时CD4+,CD8+T淋巴细胞表面共刺激分子CD28均显著升高(均P<0.01);SA组与ACS组比较差异无统计学意义。与对照组相比,SA组CD4+,CD8+T淋巴细胞表面CTLA4表达均显著升高(P<0.01);而ACS组CD4+,CD8+T淋巴细胞表面CTLA4表达均显著下降(P<0.01)。各组B7-1的表达差异无统计学意义。结论:①共刺激分子B7-1:CD28/CTLA4途径参与了冠心病的发病过程;②ACS的强烈的炎症反应与CT-LA4的低表达有关。
Objective: To investigate the changes of monocyte costimulatory molecule CD28, cytotoxic T lymphocyte antigen (CTLA) 4 and CD80 (B7-1) in peripheral blood of patients with acute coronary syndrome (ACS) and to explore the role of these molecules in pathogenesis significance. Methods: The expression of CD28, CTLA4, CD8 + T lymphocytes in peripheral blood of 23 ACS patients (ACS group) and 31 patients with stable angina pectoris (SA group) at admission were detected by direct fluorescent labeling flow cytometry. 1 molecule expression, while 15 healthy people were selected as a control (control group). Results: Compared with the control group, the CD28 expression of costimulatory molecules on CD4 + and CD8 + T lymphocytes was significantly increased in SA and ACS groups (all P <0.01). There was no significant difference between SA group and ACS group. Compared with the control group, CTLA4 expression on CD4 + and CD8 + T lymphocytes in SA group was significantly increased (P <0.01), while CTLA4 expression on CD4 +, CD8 + T lymphocytes in ACS group was significantly decreased (P <0.01). The expression of B7-1 in each group had no statistical significance. Conclusions: ① The costimulatory molecules B7-1: CD28 / CTLA4 are involved in the pathogenesis of coronary heart disease; ② The strong inflammatory reaction of ACS is related to the low expression of CT-LA4.