| Objective: To study the changes of peripheral blood T lymphocyte subsets in patients with chronic heart failure(CHF)before and after cardiac exercise rehabilitation therapy,to explore the effect of CHF exercise rehabilitation therapy on immune inflammatory injury,and to provide new ideas for the effect and mechanism of CHF rehabilitation therapy.Methods: Selection in November 2017 to December 2019 in our hospital geriatric medicine and cardiovascular internal medicine hospital in New York heart association(NYHA)?-? level 60 cases of patients with CHF,and random distribution,30 patients according to conventional treatment of heart failure guide(conventional treatment group),15 cases of men,women,15 cases,mean age 69.40±12.31 years old;Another 30 patients received cardiac exercise rehabilitation on the basis of conventional treatment(conventional treatment + exercise rehabilitation group),including 18 males and 12 females,with an average age of 64.13±11.97 years.In addition,30 hospitalized non-CHF patients(control group)were selected during the same period,including 15 males and 15 females,with an average age of 64.07±11.85 years.1.To collect all the research object of peripheral blood in the morning,using flow cytometry was developed for the determination of peripheral blood T lymphocyte subsets of total T cell percentage,T lymphocyte percentage,T lymphocyte percentage inhibition,calculation of T helper lymphocytes /T inhibit the expression of lymphocyte ratio,using immunofluorescence in patients with CHF dry method of quantitative determination of peripheral blood value of brain natriuretic peptide,and 6-minute walking text and quality of life rating scale of Minnesota.2.All CHF patients with routine therapy and routine therapy + rehabilitation group in CHF exercise rehabilitation on the basis of conventional treatment,two groups of treatment again after 1 month total T lymphocytes percentage extraction of venous blood analysis,T lymphocyte percentage,T lymphocyte percentage inhibition,calculation of T helper lymphocytes /T inhibit the expression of lymphocyte ratio as well as the value of brain natriuretic peptide,and again in 6-minute walking text and quality of life rating scale.Results: The percentage of total T lymphocytes,the percentage of T helper lymphocytes and the ratio of T helper lymphocytes /T inhibitory lymphocytes in peripheral blood in the routine treatment + exercise rehabilitation group and the routine treatment group were lower than those in the control group(P<0.05).However,the percentage of T inhibited lymphocytes increased compared with the control group(P<0.05);2.After treatment,the percentage of total T lymphocytes,the percentage of T helper lymphocytes,and the ratio of T helper lymphocytes /T inhibitory lymphocytes in the peripheral blood of the two groups all increased compared with that before treatment(P<0.05),and the percentage of T helper lymphocytes in the routine treatment + exercise rehabilitation group increased significantly,with significant difference between the two groups(P<0.05).The percentage of T inhibited lymphocytes was all decreased(P<0.05),and the decrease was more significant in the conventional treatment + exercise rehabilitation group,with a significant difference between the two groups(P<0.05);3.The walking distance increased in both groups within 6 minutes after treatment(P<0.05),and the increase was more significant in the conventional treatment + exercise rehabilitation group(P<0.05).Minnesota quality of life scale score and brain natriuretic peptide value were both decreased,and the decrease was more significant in routine treatment + exercise rehabilitation group(P<0.05);4.The 6-minute walking distance of exercise rehabilitation treatment patients was positively correlated with total t-lymphocyte percentage,t-helper lymphocyte percentage and t-helper lymphocyte /T inhibitory lymphocyte ratio(r=0.688,P=0.000).R = 0.780,P = 0.000;R = 0.555,P = 0.000);BNP was negatively correlated with total t-lymphocyte percentage,t-helper lymphocyte percentage,and t-helper lymphocyte /T inhibitory lymphocyte ratio(r=-0.742,P=0.000;R = 0.802,P = 0.000;R = 0.255,p = 0.004);MLHFQ was negatively correlated with the percentage of total T lymphocytes,the percentage of T helper lymphocytes,and the ratio of T helper lymphocytes to T inhibitory lymphocytes(r=-0.560,P=0.000;R = 0.614,P = 0.000;R =-505,P = 0.000).Conclusion: 1.The T lymphocyte subsets in peripheral blood of CHF patients were lower than that of non-CHF patients in total T lymphocyte percentage,T helper lymphocyte percentage,T helper lymphocyte /T inhibitory lymphocyte percentage,and T inhibitory lymphocyte percentage increased,suggesting that there were changes in immune function in CHF patients;2.Exercise rehabilitation intervention for CHF patients on the basis of conventional treatment can improve clinical symptoms and quality of life,and is related to changes in peripheral blood T lymphocyte subsets.The mechanism may be related to the regulation of immune injury in CHF patients,providing new ideas for the effect and mechanism of exercise rehabilitation treatment for CHF patients. |
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