老年单纯收缩期高血压患者外周血T淋巴细胞亚群和脉压的关系

摘要

Objective To investigate the relationship between peripheral blood T lymphocyte subsets and pulse pressure(PP)in elderly patients with isolated systolic hypertension(ISH). Methods Seventy elderly ISH patients(ISH group)and 32 health elderly subjects(control group) were enrolled in this study.In addition,ISH patients were divided into PP<60 mmHg group(n=33)and PP≥60 mmHg group(n=37).The percentages of CD3,CD4+ and CD8+ T cells and CD4+/CD8+ ratio were compared among the four groups.The relationship between peripheral blood T lymphocyte subsets and PP was analyzed.Results Compared with control group,the per-centages of CD3,CD4+ and CD8+ T cells decreased but CD4+/CD8+ ratio increased in ISH group (P<0.05 or P<0.01).Compared with PP<60 mmHg group,the percentage of CD8+ T cells de-creased but CD4+/CD8+ ratio increased in PP≥60 mmHg group(P<0.05).No significant differ-ences in the percentages of CD3 and CD4+ T cells between PP<60 mmHg group and PP≥ 60 mmHg group(P>0.05).The percentage of CD8+ T cells was positively correlated with PP (r2=0.508,P<0.05).However,the percentages of CD3 and CD4+ T cells were negatively corre-lated with PP(r2=-0.443,P<0.05).Conclusion The increase in PP is associated with immune dysfunction in elderly ISH patients.The increased PP and impaired immune function are impor-tant influence factors in the process of atherosclerosis in elderly patients with ISH.%目的：探讨老年单纯收缩期高血压患者（isolated systolic hypertension，ISH）外周血T淋巴细胞亚群和脉压（pulse pressure，PP）的关系。方法选取70例老年 ISH患者（ISH组）及32例健康老年人（对照组）为研究对象，其中 ISH组按PP水平分为PP＜60 mmHg（1 mmHg＝0．133 kPa）组（n＝33）和PP≥60 mmHg组（n＝37）。比较对照组与 ISH组、PP＜60 mmHg组和PP≥60 mmHg组患者的 CD3、CD4＋、CD8＋T细胞百分率和 CD4＋/CD8＋比值；分析 ISH组PP≥60 mmHg 组 T 淋巴细胞亚群与 PP 水平的关系。结果与对照组比较，ISH 组 CD3、CD4＋、CD8＋百分率降低、CD4＋/CD8＋比值增高（P＜0．05或P＜0．01）。与 PP＜60 mmHg组比较，PP≥60 mm-Hg组CD8＋T细胞百分率降低、CD4＋/CD8＋比值增高（均P＜0．05）；2组 CD3、CD4＋百分率差异无统计学意义（P＞0．05）。CD8＋细胞水平与 PP 水平呈正相关（r2＝0．508，P＜0．05），CD4＋/CD8＋比值与 PP 水平呈负相关（r2＝-0．443，P＜0．05）。结论老年 ISH患者PP增大与免疫功能受损有关，PP及免疫功能紊乱是老年 ISH 患者动脉粥样硬化过程中的重要影响因子。