系统性红斑狼疮合并冠状动脉性心脏病患者Th1／Th2失衡的研究

摘要

目的：探讨系统性红斑狼疮（SLE）合并冠状动脉性心脏病（简称冠心病）患者的 Th1／Th2是否存在失衡状况。方法收集 SLE 患者（SLE 组）、SLE 合并冠心病患者（合并组）及健康对照者（对照组）外周血，real-time PCR 法检测外周血 Th1／Th2细胞转录因子 T-bet／GATA-3的表达；流式细胞术检测 Th1／Th2细胞内 IFN-γ及 IL-4水平；酶联免疫吸附法（ELISA）检测患者外周血清中 IFN-γ及 IL-4水平并与对照组比较。结果 SLE 组患者外周血 Th1细胞转录因子 T-bet 表达水平、CD4＋ T 细胞内 IFN-γ分泌水平及血清 IFN-γ水平均明显低于对照组（P＜0．05）。合并组患者外周血 Th1细胞转录因子 T-bet 表达水平、CD4＋ T 细胞内 IFN-γ分泌水平及血清 IFN-γ水平均明显高于 SLE 组患者及对照组（P＜0．05）；合并组患者外周血 Th2细胞转录因子 GATA-3表达水平、CD4＋ T 细胞胞内 IL-4分泌水平及血清 IL-4水平均明显低于 SLE 组患者及对照组（ P ＜0．05）。结论 SLE合并冠心病患者存在 Th1优势活化的 Th1／Th2失衡状态，这种失衡状态可能与疾病的发生发展有关。%Objective To investigate the imbalance of Th1/Th2 cell response in patients with systemic lupus erythematosus (SLE) combined with coronary heart disease .Methods SLE patients ,SLE patients with coronary heart disease and healthy con-trols were enrolled and blood samples were collected .T-bet/GATA-3 ,the transcription factors of Th1/Th2 cells ,were detected by real-time PCR ;the intracellular cytokines IFN-γ and IL-4 in CD4 + T cells were stained by fluorescent antibodies and detected by flow cytometry ;the level of serum IFN-γ and IL-4 were detected by ELISA .Results Comparing with healthy control group ,the ex-pression level of Th1 transcription factor T-bet ,the introcellular secretion of IFN-γ in CD4 + T cells and the serum IFN-γ were all decreased in non-coronary heart disease patients with SLE( P < 0 .05) .Comparing with non-coronary heart disease patients with SLE or healthy control group ,the expression level of Th1 transcription factor T-bet ,the introcellular secretion of IFN-γ in CD4 + T cells and the serum IFN-γ were all increased in patients with SLE combined coronary heart disease(P< 0 .05) ;while the expression level of Th2 transcription factor GATA-3 ,the introcellular secretion of IL-4 in CD4 + T cells and the serum IL-4 were all decreased in patients with SLE combined coronary heart disease(P< 0 .05) .Conclusion There were imbalance towards Th1 cell response in patients with SLE combined coronary heart disease ,which may related to the occurrence and development of disease .