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目的探讨慢性心力衰竭(CHF)患者外周血中Th17细胞、CD4+CD25+Foxp3+调节性T细胞(Treg)的变化及意义。方法 49例CHF患者按照NYHA心功能分级分为CHF1组(NYHA心功能Ⅰ～Ⅱ级,n=21)和CHF2组(NYHA心功能Ⅲ～Ⅳ级,n=28)。18例健康体检者作为对照组。采用流式细胞分析法检测外周血中Th17、Treg细胞占CD4+T细胞的比例。结果 CHF1组和CHF2组患者外周血中Th17/CD4+T细胞的比例明显高于对照组(P均<0.01),CHF2组亦明显高于CHF1组(P<0.01);CHF1组和CHF2组患者外周血中Treg/CD4+T细胞的比例明显低于对照组(P均<0.01),CHF2组亦明显低于CHF1组(P<0.05);Th17/Treg的比值随心功能的减低而增高(P<0.01)。结论 CHF患者外周血中存在Th17/Treg失衡,且与心功能有一定关系,Th17/Treg失衡可能参与了CHF的发生发展。
Objective To investigate the changes and significance of Th17 cells, CD4 + CD25 + Foxp3 + regulatory T cells (Tregs) in peripheral blood of patients with chronic heart failure (CHF). Methods 49 patients with CHF were divided into CHF1 group (NYHA class Ⅰ ~ Ⅱ, n = 21) and CHF2 group (NYHA class Ⅲ ~ Ⅳ grade, n = 28) according to NYHA functional class. Eighteen cases of healthy people as control group. Flow cytometry was used to detect the proportion of Th17 and Treg cells in CD4 + T cells in peripheral blood. Results The proportion of Th17 / CD4 + T cells in CHF1 group and CHF2 group was significantly higher than that in control group (P <0.01), CHF2 group was also significantly higher than CHF1 group (P <0.01); CHF1 group and CHF2 group The proportion of Treg / CD4 + T cells in peripheral blood was significantly lower than that in control group (P <0.01), but also significantly lower in CHF2 group than in CHF1 group (P <0.05). The ratio of Th17 / Treg increased with decreasing cardiac function <0.01). Conclusion There is imbalance of Th17 / Treg in peripheral blood of patients with CHF, which may be related to cardiac function. The imbalance of Th17 / Treg may be involved in the development of CHF.