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目的 比较急性冠状动脉综合征(acute coronary syndrome,ACS)患者周围血和冠状动脉罪犯血管病变处血辅助性T细胞17 (helper T cells,Th17)占CD4+T细胞的比例以及IL-17水平,分析其临床意义.方法 序贯入选2012年2月15 日至2012年10月15日杭州师范大学附属医院接受冠状动脉造影(CAG)的冠心病(coronary heart disease,CHD)及疑诊冠心病患者76例.分为ACS组、稳定性心绞痛(stable angina,SA)组和对照组.所有患者均在做完冠状动脉造影后即刻采集肘静脉血5 mL.ACS患者同时采集罪犯血管病变处血5 mL.采用流式细胞术检测不同部位血 Th17的百分率.用ELISA法检测不同部位血血清白细胞介素(interleukin,IL)-17的质量浓度.结果 ACS患者周围血Th17细胞占CD4+T细胞的比例和冠状动脉罪犯血管病变处血 Th17细胞占CD4+T细胞的比例分别是(3.18±0.29)％和(3.17±0.30)％,差异无统计学意义(P =0.919).ACS组、SA组和对照组外周血 Th17细胞占CD4+T细胞的比例分别是(3.18±0.29)％、(1.32±0.31)％和(1.28±0.33)％,ACS组与另外两组相比差异均有统计学意义(P＜0.01),但SA组和对照组比较,差异无统计学意义.ACS外周血和冠状动脉罪犯血管病变处血血清IL-17质量浓度分别是(81.23±18.63) pg/mL和(82.37 ±20.51) pg/mL,差异无统计学意义(P =0.573).ACS组外周血IL-17水平分别与SA组和对照组相比,差异均有统计学意义.但SA组和对照组比较差异无统计学意义.结论 ACS患者周围血 Th17细胞百分比以及IL-17水平与冠状动脉罪犯血管病变处相似,原因可能是多方面的.ACS患者外周血 Th17细胞比例增加、IL-17水平升高,这可能参与动脉粥样硬化斑块不稳定的形成,这个过程导致ACS发病.“,”Objective To investigate the differences and significance of blood levels of T helper 17 (Th17) cell and interleukin17 (IL-17) between peripheral and culprit vessels in patients with acute coronary syndrome.Methods A total of 76 patients recruited in 2012 were divided into three groups according to the coronary angiography and clinical manifestations:acute coronary syndrome,stable angina and control groups.The blood samples were taken from cubital vein and culprit coronary artery after coronary angiography.The percentage of Th17s among CD4+ T cells was detected by flow cytometric analysis and the IL-t7 levels were measured by enzyme-linked immunosorbent assay.Results There was no significant difference in the percentages of Th17 cells between peripheral blood and culprit artery blood [(3.18 ± 0.29) ％ vs.(3.17 ±0.30)％,(P =0.919)];but the perecentages of Th17 in peripheral blood were found to be significantly higher in patients with acute coronary syndrome (3.18 ± 0.29)％ than those with stable angina (1.32 ± 0.31) ％ and those without coronary heart disease (1.28 ± 0.33) ％,(P ＜ 0.01).There was no significant difference in the level of IL-17 between peripheral blood and culprit artery blood [(81.23 ± 18.63) vs.(82.37 ±20.51) pg/mL,P =0.573];but the level of IL-17 in peripheral blood was also significantly higher in patients with acute coronary syndrome than those with stable angina and those without coronary heart disease [(81.23 ± 18.63) vs.(25.96 ± 14.58) pg/mL or (23.75 ± 13.64) pg/mL,P ＜0.01].Conclution There were no significant differences in percentage of Th17 cell among CD4 + T cells and levels of IL-17 in blood between peripheral and culprit vessels in patients with acute coronary syndrome.The percentage of Th17 among CD4 + T cells and the levels of IL-17 in blood increase in patients with acute coronary syndrome suggesting a potential role of Th17 and IL-17 in the development and instability of the atheroma.