目的 探讨慢性心力衰竭(CHF)患者外周血中Th17细胞、CD4+ CD25+ CD127-调节性T细胞(Treg)的变化及意义.方法 53例CHF患者按照NYHA心功能分级分为CHF1组(NYHA心功能Ⅰ～Ⅱ级,n=24)和CHF2组(NYHA心功能Ⅲ～Ⅳ级,n=29).20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细胞、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(1.89±1.24 vs 0.51±0.35,3.35±1.78 vs 0.51±0.35;P＜0.05;P＜0.01),CHF2组亦明显高于CHF1组(3.35±1.78 vs 1.89±1.24,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(5.69±0.74 vs 7.89±1.66,3.31±0.98 vs 7.89±1.66;P＜0.01;P＜0.01),CHF2组亦明显低于CHF1组(3.31±0.98 vs 5.69±0.74,P＜0.01);CHF1组和CHF2组患者Th17/Treg的比值明显高于对照组(0.35±0.17 vs 0.11±0.09,1.06±0.49 vs 0.11±0.09;P＜0.05;P＜0.01),CHF2组亦明显高于CHF1组(1.06±0.49 vs 0.35±0.17,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 explore the significance of the imbalance between Th17 and CD4+ CD25+CD127 - regulatory T cells(Treg) in patients with chronic heart failure(CHF). Methods Peripheral blood were collected from 53 patients with CHF or 20 healthy controls. The 53 patients were divided into the CHF1 group( NYHA Ⅰ -Ⅱ , n = 24 ) or CHF2 group ( NYHA Ⅲ -Ⅳ, n = 29 ), according to NYHA heart function class. The proportion of Th17 and CD4 + CD25 + CD127 - Treg was detected by flow cytometry. Results The proportion of Th17 cells was significantly higher in the patients of CHF1 and CHF2 group than that in healthy control( 1.89±1.24 vs 0. 51 ±0.35,3.35 ± 1.78 vs 0.51 ±0.35; P ＜0.05; P ＜0.01 ) ,The proportion of Th17 cells was significantly higher in patients with CHF2 group than that in patients with CHF1 group(3.35 ± 1.78 vs 1.89 ± 1.24 ,P ＜0.01 ); The proportion of CD4 +CD25 + CD127 - Treg was significantly lower in patients with CHF1 group and CHF2 group than that in healthy controls(5.69 ±0.74 vs 7.89 ± 1.66,P ＜0. 01; 3.31 ±0.98 vs 7.89 ± 1.66,P ＜0. 01 ). The proportion of CD4+CD25 + CD127 - Treg was significantly lower in the patients of CHF2 group than that in CHF1 group(3.31 ±0.98 vs 5.69 ± 0.74, P ＜ 0. 01 ). The ratio of Th17/Treg was significantly higher in patients with CHF1 group and CHF2 group than that in healthy control (0.35 ± 0. 17 vs 0.11 ± 0.09, P ＜ 0.05; 1.06 ± 0.49 vs 0.11 ± 0. 09, P ＜ 0.01 ).and it was confirmed that the ratio of Th17/Treg was significantly higher in patients with CHF2 group than that in patients with CHF1 group( 1.06 ± 0.49 vs 0.35 ± 0.17, P ＜ 0.01 ). Conclusion Th17/Treg imbalance exists in patients -with CHF, and it may play a potential role in the onset and development of CHF.
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