Th22细胞及其细胞因子IL-22在冠心病患者水平测定及其与冠脉病变的相关性

发布时间：2018-03-02 11:11

本文关键词： 冠状动脉粥样硬化性心脏病 Th22细胞 IL-22 Gensini评分　出处：《长江大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:观察冠心病患者外周血Th22细胞及其细胞因子IL-22的水平变化,以及分析Th22及IL-22与冠心病的关系及与冠脉病变的相关性,探讨Th22及其细胞因子IL-22在冠心病中的作用机制,为诊断冠心病提供新的辅助指标,为评估冠状动脉病变程度提供更快捷更有效的方法。方法:选取2015年11月至2016年9月在荆州市中心医院心血管内科住院的冠心病患者60例及同期20例冠脉造影正常者为健康对照组,其中男49例,女31例,年龄54-81岁,平均年龄65.00±8.12岁。其中冠心病患者依据相关诊断指南分为三组,分别为稳定型心绞痛组(SAP)20例,不稳定型心绞痛组(UAP)20例,急性心肌梗死组(AMI)20例。20例健康对照组(HC)为冠脉照影正常者,体格检查:血常规、血脂、血糖、肝肾功能均正常,运动负荷心电图结果为阴性。所有入选对象在年龄、性别、吸烟、饮酒、高血压、体重指数、糖尿病史、血脂异常等方面未见显著差异(P0.05),具有可比性。且所有对象排除先心病、肺心病、合并风湿性心脏病及其他严重的心脏瓣膜病、合并各种心肌病、合并肿瘤、心力衰竭、肝肾功能不全、创伤、感染、周围血管病变、自身免疫性疾病,以及3个月内进行心脏外科或介人手术。四组对象均抽取静脉血。懫血时间:AMI组于发病后24h之内;UAP组、SAP组及HC组于清晨空腹状态下抽取。所有标本在30min内3000r/min离心10min,分离血清后密封封管,置于-80℃低温冰箱中保存待测。采用流式细胞仪检测外周血Th22细胞在CD4+T细胞中的比例,采用酶联免疫吸附法(ELISA)测定各组外周血血浆IL-22的表达水平。冠心病组行冠脉造影,依据冠脉造影结果使用Gensini评分系统评价冠脉病变程度。结果:AMI组血浆Th22细胞在CD4+T细胞中的比例(2.02±0.84)%、IL-22浓度(39.12±5.41)pg/ml,显著高于SAP组(0.74±0.27)%、(28.14±3.78)pg/ml,UAP组(1.20±0.34)%、(33.50±3.47)pg/ml及HC组(0.48±0.19)%、(25.38±3.13)pg/ml,差异均具有统计学意义(p0.05);UAP组与SAP组和HC组差异有统计学意义(p0.05);SAP组与HC组差异有统计学意义(p0.05)。AMI组、UAP组及SAP组患者的Th22细胞比例与IL-22浓度均呈显著正相关,γ分别为0.877,0.764,0.968,p0.001。Th22和IL-22与Gensini评分呈显著正相关,person分析结果,γ分别为0.962,0.889,p均0.001。结论:(1)Th22细胞及其细胞因子IL-22参与冠状动脉粥样硬化性心脏病发生发展过程,且Th22及IL-22水平反映了动脉粥样斑块的急性炎症程度。(2)各组间Th22与IL-22呈正相关,提示在冠心病中参与炎症反应的IL-22主要由Th22产生。(3)Th22及IL-22与Gensini评分呈正相关,可以间接反映冠脉的狭窄程度。综上所述:Th22及IL-22的检测可作为诊断冠心病的一种辅助方法,且Th22及IL-22水平的高低可作为初步判断冠脉狭窄程度的一种无创的、安全的指标。
[Abstract]:Objective: to observe the changes of Th22 cells and their cytokines IL-22 in peripheral blood of patients with coronary heart disease, to analyze the relationship between Th22 and IL-22 and coronary artery disease, and to explore the mechanism of Th22 and its cytokine IL-22 in coronary heart disease. To provide new supplementary indicators for the diagnosis of coronary heart disease, Methods: from November 2015 to September 2016, 60 patients with coronary artery disease hospitalized in Department of Cardiovascular Medicine, Jingzhou Central Hospital, and 20 patients with coronary angiography were selected to evaluate the severity of coronary artery disease. The normal subjects were healthy control group, There were 49 males and 31 females, aged 54-81 years, with an average age of 65.00 卤8.12 years. The patients with coronary heart disease were divided into three groups according to the relevant diagnostic guidelines, 20 patients with stable angina pectoris and 20 patients with unstable angina pectoris, 20 patients with unstable angina pectoris, 20 patients with unstable angina pectoris, 20 patients with unstable angina pectoris and 20 patients with unstable angina pectoris. 20 patients with AMI in acute myocardial infarction group and 20 healthy control group (HC1) as normal coronary radiographs. Physical examination: blood routine examination, blood lipid, blood glucose, liver and kidney function were normal, exercise load electrocardiogram results were negative. All subjects were enrolled in age, sex, blood glucose, liver and kidney function. There was no significant difference in smoking, drinking, hypertension, body mass index (BMI), history of diabetes, dyslipidemia and so on. All subjects were excluded from congenital heart disease, cor pulmonale, rheumatic heart disease and other serious heart valvular diseases. Complicated with a variety of cardiomyopathy, cancer, heart failure, liver and kidney dysfunction, trauma, infection, peripheral vascular disease, autoimmune disease, The venous blood was drawn from all the four groups within 24 hours after onset of the disease. All samples were centrifuged within 30 minutes after 30 minutes in the SAP group and the HC group in the UAP group and the HC group in the morning fasting state. After 10 mins, the serum was sealed and sealed. The proportion of peripheral blood Th22 cells in CD4 T cells was detected by flow cytometry, and the expression of IL-22 in peripheral blood was measured by enzyme linked immunosorbent assay (Elisa). Coronary arteriography was performed in coronary heart disease group. Results the ratio of plasma Th22 cells to CD4 T cells was 2.02 卤0.84g / ml, which was significantly higher than that in SAP group (28.74 卤0.27pg / ml), 28.14 卤3.78pg / ml UAP group (1.20 卤0.34pg / ml) and HC group (0.48 卤0.19g / ml 0.48 卤0.19g / ml, 25.38 卤3.13pg / ml, respectively), which was significantly higher than that in SAP group (28.14 卤3.78pg / ml) and HC group (0.48 卤0.19g / ml, 25.38 卤3.13pg / ml). There was a significant difference between SAP group and HC group. There was a significant positive correlation between the percentage of Th22 cells and the concentration of IL-22 in Th22 group and SAP group, 纬 = 0.8770.764U P 0.001.Th22 and IL-22 and Gensini scores, respectively. The results of Guan person's analysis showed that 纬 was 0.9620.889p and 0.001.Conclusion the IL-22 of Th22 and its cytokine are involved in the development of coronary atherosclerotic heart disease. The levels of Th22 and IL-22 reflected the degree of acute inflammation of atherosclerotic plaques. There was a positive correlation between Th22 and IL-22, suggesting that the IL-22 involved in inflammation in coronary heart disease was mainly produced by Th22. Th22 and IL-22 were positively correlated with Gensini score. In conclusion, the detection of the ratio of Th22 and IL-22 can be used as an auxiliary method for the diagnosis of coronary artery disease, and the levels of Th22 and IL-22 can be used as a noninvasive and safe index to judge the degree of coronary stenosis.
【学位授予单位】：长江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.4

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