| ObjectiveAs the living standards and lifestyle changes, the incidence of coronary heart disease with diabetes significantly increased. In recent years,a large number of studies have found that inflammation and immune mechanism take an important part in the pathophysiological process of coronary heart disease and diabetes. A lot of cytokines take an important part in the process.In our study, we tested and compared the Th1/Th2 cell ratio in control group,coronary heart disease diabetes group(CHD group)and coronary heart disease with diabetes group(CHD+DM group) to investigate the effect of these cytokines on the genesis and development of coronary heart disease with diabetes and evaluate the effect of rosuvastatin intervence. At the same time,It could provide a new approach to the condition of patients with both diabetes and coronary heart disease monitoring, prognosis and treatment.MethodFrom October 2010 to April 2011,94 cases of hospitalized patients were included in this study.68 patients were diagnosed coronary heart disease according to coronary angiography or coronary 320 CT result,and others are normal.At the same time,according to glucose tolerance test (OGTT experiment), the coronary heart disease patients were grouped as follows: CHD group, CHD+DM group. All patients admitted to hospital were taked fasting venous blood the next morning.All patients were tested blood serum lipids, blood glucose, liver function, renal function and other biochemical markers. Extracted 5ml fresh peripheral fasting blood and drown into sodium heparin anticoagulant tubes, immediately isolated by density gradient centrifugation of peripheral blood mononuclear cells(PBMC). Then the PBMC were stimulated and incubated by stimulant for 4 hours at 37°C/5% CO2 incubator.Then the samples after stimulation were stained with CD3-FITC antibody in order to label T lymphocytes. After rupture of membrane, the intracellular cytokines were stained with PE-IFN-γor PE-IL-4 antibody. Finally, the samples were tesed by flow cytometry.Th1/Th2 cell ratio were expressed as CD3+ T cell subsets of cytokines in the percentage of positive staining cells. Finally, coronary heart disease patients with diabetes oraled rosuvastatin 1 month ,and then observed the changes of items above. At the same time, we could observed the immunomodulatory effects of statins.Results1) Patient characteristics. There were no significant differences in age, gender, lipid, blood glucose, hypertension, or frequency of smoking in CHD,CHD+DM or control group.2) Th1/Th2 cell ratio among the groups: Compared with control group, the Th1 cell ratio (IFN-γ/CD3 percentage) of CHD group was significantly higher, and there was significant difference (P <0.01); The Th2 cell ratio (IL-4/CD3) was lower than the control group patients, there was significant difference (P<0.05).Compared with the CHD group and control group, the Th1 cell ratio (IFN-γ/CD3 percentage )of the CHD+DM group was significantly higher (P <0.01); There was significantly different in the Th2 cell ratio (the percentage of IL-4/CD3) between the control group, CHD group and CHD+DM group (P<0.05) .3) The analysis of the characteristics of coronary artery disease: The CHD+DM patients had usually more severe coronary artery disease than CHD patients, reflected in: Multivessel coronary artery is usually involved, and diffuse lesions in the CHD+DM patients (P <0.05).4) The change in blood lipids of Coronary heart disease patients with diabetes mellitus taking rosuvastatin 1 month after: Plasma total cholesterol (CH), low-density lipoprotein cholesterol (LDL-CH) compared with those before treatment were significantly decreased (P <0.05),high density lipoprotein cholesterol (HDL-C) and TG were no significant change.5) Effect of rosuvastatin on the serum level of Thl/Th2 cell ratio in all groups: Compared with before treatment, the Th1 cell ratio( IFN-γ/CD3) was significantly lower (P <0.01). The Th1 cell ratio ( IL-4/CD3 )was increased, and there was significant difference (P<0.05).ConclusionOur study found that: compared with patients with normal blood sugar, diabetic patients with coronary heart disease combined more severe immune and inflammatory responses usually.The Th1 cell ratio of coronary heart disease patients with diabetes, was significantly higher than CHD and control group.It suggested that patients with both diabetes mellitus and coronary heart disease, is not a simple problem of lowering blood sugar, but levels in control and integrated treatment of inflammation. Coronary heart disease patients with diabetes in the statin drug treatment, not only lipid-lowering, but also can significantly reduce the levels of Th1 cell ratio , increase the levels of Th2 cell ratio,to improve the imbalance of Th1/Th2 cell subsets to stabilize and control the development of atherosclerotic plaques and delay the occurrence of atherosclerosis progress. |
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