中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2010年
10期
1023-1025
,共3页
田秀青%梁江久%刘建华%董玉玲%吴丙云
田秀青%樑江久%劉建華%董玉玲%吳丙雲
전수청%량강구%류건화%동옥령%오병운
心力衰竭%γ-干扰素%白细胞介素-10%心率变异性
心力衰竭%γ-榦擾素%白細胞介素-10%心率變異性
심력쇠갈%γ-간우소%백세포개소-10%심솔변이성
Heart failure%Interferon-γ%Interleukin-10%Heart rate variability
目的 探讨慢性心力衰竭(CHF)患者T辅助淋巴细胞(Th)和心率变异性(HRV)的相关性.方法 选择CHF患者96例及健康体检者30名为研究对象,以γ-干扰素(IFN-γ)和白细胞介素-10(IL-10)分别代表Th1和Th2细胞,采用流式细胞仪测定所有入选者外周血淋巴细胞内细胞因子IFN-γ和IL-10的阳性率,用24 h动态心电图(Holter)分析HRV特征.结果 CHF患者淋巴细胞IL-10阳性率明显低于健康对照组[(16.4±5.8)%、(26.8±3.7)%,t=9.243,P＜0.001],淋巴细胞IFN-γ阳性率明显高于健康对照组[(18.4±7.3)%、(7.3±4.6)%t=7.917,P＜0.001];HRV各指标均明显低于健康对照组,24 h正常心动周期的标准差(SDNN)为(9 8.6±21.3)、(145.1±42.6)ms,24 h内5 min节段平均心动周期的均值标准差(SDANN)为(83.9±22.4)、(136.5±39.6)ms,标准差平均值指数(SDNNI)为(40.6±14.5)、(55.8±17.9)ms,相邻正常心动周期差值均方根(RMSSD)为(20.7±12.9)、(29.1±12.6)ms,相邻两正常心动周期差值＞50 ms的个数所占的百分比(PNN50)为(5.6±3.7)%、(11.8±4.4)%(t值分别为7.904、9.645、4.733、3.132、7.654,P均＜0.05),CHF患者IL-10阳性率与SDNN、SDANN、SDNNI、RMSSD、PNN50呈显著正相关(r值分别为0.49、0.57、0.58、0.47、0.52,P均＜0.01),IFN-γ阳性率及IFN-γ/IL-10比值与SDNN、SDANN、SDNNI、RMSSD、PNN50均呈显著负相关(r值分别为-0.49、-0.54、-0.57、-0.52、-0.53,-0.52、-0.64、-0.57、-0.58、-0.67,P均＜0.01).结论 CHF患者自主神经系统参与Th1/Th2平衡调节,交感神经系统促进Th1效应,副交感神经系统促进Th2效应.
目的 探討慢性心力衰竭(CHF)患者T輔助淋巴細胞(Th)和心率變異性(HRV)的相關性.方法 選擇CHF患者96例及健康體檢者30名為研究對象,以γ-榦擾素(IFN-γ)和白細胞介素-10(IL-10)分彆代錶Th1和Th2細胞,採用流式細胞儀測定所有入選者外週血淋巴細胞內細胞因子IFN-γ和IL-10的暘性率,用24 h動態心電圖(Holter)分析HRV特徵.結果 CHF患者淋巴細胞IL-10暘性率明顯低于健康對照組[(16.4±5.8)%、(26.8±3.7)%,t=9.243,P＜0.001],淋巴細胞IFN-γ暘性率明顯高于健康對照組[(18.4±7.3)%、(7.3±4.6)%t=7.917,P＜0.001];HRV各指標均明顯低于健康對照組,24 h正常心動週期的標準差(SDNN)為(9 8.6±21.3)、(145.1±42.6)ms,24 h內5 min節段平均心動週期的均值標準差(SDANN)為(83.9±22.4)、(136.5±39.6)ms,標準差平均值指數(SDNNI)為(40.6±14.5)、(55.8±17.9)ms,相鄰正常心動週期差值均方根(RMSSD)為(20.7±12.9)、(29.1±12.6)ms,相鄰兩正常心動週期差值＞50 ms的箇數所佔的百分比(PNN50)為(5.6±3.7)%、(11.8±4.4)%(t值分彆為7.904、9.645、4.733、3.132、7.654,P均＜0.05),CHF患者IL-10暘性率與SDNN、SDANN、SDNNI、RMSSD、PNN50呈顯著正相關(r值分彆為0.49、0.57、0.58、0.47、0.52,P均＜0.01),IFN-γ暘性率及IFN-γ/IL-10比值與SDNN、SDANN、SDNNI、RMSSD、PNN50均呈顯著負相關(r值分彆為-0.49、-0.54、-0.57、-0.52、-0.53,-0.52、-0.64、-0.57、-0.58、-0.67,P均＜0.01).結論 CHF患者自主神經繫統參與Th1/Th2平衡調節,交感神經繫統促進Th1效應,副交感神經繫統促進Th2效應.
목적 탐토만성심력쇠갈(CHF)환자T보조림파세포(Th)화심솔변이성(HRV)적상관성.방법 선택CHF환자96례급건강체검자30명위연구대상,이γ-간우소(IFN-γ)화백세포개소-10(IL-10)분별대표Th1화Th2세포,채용류식세포의측정소유입선자외주혈림파세포내세포인자IFN-γ화IL-10적양성솔,용24 h동태심전도(Holter)분석HRV특정.결과 CHF환자림파세포IL-10양성솔명현저우건강대조조[(16.4±5.8)%、(26.8±3.7)%,t=9.243,P＜0.001],림파세포IFN-γ양성솔명현고우건강대조조[(18.4±7.3)%、(7.3±4.6)%t=7.917,P＜0.001];HRV각지표균명현저우건강대조조,24 h정상심동주기적표준차(SDNN)위(9 8.6±21.3)、(145.1±42.6)ms,24 h내5 min절단평균심동주기적균치표준차(SDANN)위(83.9±22.4)、(136.5±39.6)ms,표준차평균치지수(SDNNI)위(40.6±14.5)、(55.8±17.9)ms,상린정상심동주기차치균방근(RMSSD)위(20.7±12.9)、(29.1±12.6)ms,상린량정상심동주기차치＞50 ms적개수소점적백분비(PNN50)위(5.6±3.7)%、(11.8±4.4)%(t치분별위7.904、9.645、4.733、3.132、7.654,P균＜0.05),CHF환자IL-10양성솔여SDNN、SDANN、SDNNI、RMSSD、PNN50정현저정상관(r치분별위0.49、0.57、0.58、0.47、0.52,P균＜0.01),IFN-γ양성솔급IFN-γ/IL-10비치여SDNN、SDANN、SDNNI、RMSSD、PNN50균정현저부상관(r치분별위-0.49、-0.54、-0.57、-0.52、-0.53,-0.52、-0.64、-0.57、-0.58、-0.67,P균＜0.01).결론 CHF환자자주신경계통삼여Th1/Th2평형조절,교감신경계통촉진Th1효응,부교감신경계통촉진Th2효응.
Objective To investigate the association of T help (Th) lymphocyte and heart rate variability (HRV) in congestive heart failure (CHF) patients. Methods Ninety-six patients with CHF and thirty healthy persons were enrolled in the study. Time-domain HRV analysis was performed based on 24 hour Holter Electrocardiogram (ECG) monitoring. Interferon-γ (IFN-γ) was used as markers for the differentiation of Th1 subsets and interleukin-10 (IL-10) for the Th2 subsets. IFN-γand IL-10 in CD4 + T lymphocytes were quantified by 3-color flow cytometry. Results The frequency of IL-10-Producing T Cells in the CHF group was significantly lower than those in the healthy control ( ( 16.4 ± 5.8 ) % vs. ( 26.8 ± 3.7 ) %, t = 9. 243, P ＜ 0. 001 ). The frequency of IFN-γ in the CHF group ( ( 18.4 ± 7.3 )% ) was significantly lower than that in the healthy controls ( (7.3 ±4.6) % ,t =7. 917, P ＜ 0. 001 ). The following index of HRV in the CHF groups were all significantly lower than those in the healthy controls: (98. 6 ± 21.3) ms vs. ( 145. 1 ± 42. 6) ms for SDNN, (83. 9 ± 22.4) ms vs.(136.5 ±39.6)ms for SDANN, (40.6 ± 14.5) ms vs. (55.8 ± 17.9) ms for SDNNI, (20. 7 ± 12.9) ms vs.(29.1 ± 12.6) ms for RMSSD, (5.6 ± 3.7 ) % vs. ( 11.8 ± 4.4) % for PNN50 ( Ps ＜ 0.05 ). In CHF patients, the frequency of IL-10 were positively associated with SDNN, SDANN, SDNNI, RMSSD and PNN50 ( r = 0. 49,0. 57,0. 58,0.47 and 0. 52 ,respectively,Ps ＜ 0.01 ). In the CHF patients, the frequency of IFN-γand IFN-γ/IL-10 ratio were negatively associated with SDNN ,SDANN ,SDNNI, RMSSD and PNN50 ( r = - 0. 49, - 0. 54, - 0. 57, - 0.52,- 0.53, - 0. 52, - 0.64, - 0.57, - 0. 58, - 0. 67, Ps ＜ 0. 01 ). Conclusions Autonomic nervous system is involved in the regulation of the balance of Th1/Th2 in patients with CHF. Sympathetic nerve system enhances the effect of Th1 ,whereas parasympathetic nervous system enhances the effect of Th2.
