| Background:Coronary heart disease is a chronic inflammation-mediated autoimmune diseases, which is characterized by coronary atherosclerosis as the main lesion. There is a variety of mechanisms involved in the whole process of atherosclerosis,including thrombosis doctrine,lipid infiltration theory,a single-cloning doctrine, and so on. Recent studies have found that apoptosis and inflammatory reaction throughout the whole process of atherosclerosis. With the research progress related to atherosclerotic plaque stability, looking for sensitive specific markers that can accurately reflect the characteristics of unstable plaque to the early prediction of coronary heart disease is becoming the research hotspot. Based on the theories above, this experiment intended to observe the difference among the number of peripheral blood lymphocytes, the degree of apoptosis and the level of high sensitive C-reactive protein in patients with coronary heart disease, and then analyse the changes of apoptotic factors and hsCRP levels,and observed the predictive value of them in the stability of atherosclerotic plaques, analyse the role of them in coronary heart disease in order to provide the basis for the guidance of the clinical diagnosis and treatment of coronary heart disease.Methods:We recruited98patients with coronary heart disease, divided into three groups, of which30cases of patients with stable angina,36patients with unstable angina,and32patients with acute myocardial infarction.What’s more,30cases of healthy adults as normal control group selected from the hospital medical center. The expression characteristics of Fas (CD95), FasL (CD178) in T lymphocyte were detected with flow cytometry; serum concentrations of soluble Fas was detected with ELISA; serum concentrations of hsCRP levels was detected with luminescent technique. SPSS18.0were used for statistical analysis and comparing the levels of the above-mentioned indicators in the groups and between-group differences (P<0.05for differences was statistically significant).Results:(1)Different phenotypes of patients with coronary heart disease in peripheral blood leukocyte number were significantly higher than that of normal control group(7.72±1.89vs6.92±1.82vs6.10±1.35vs5.89±1.64,×109/L, P<0.01), while lymphocyte number were significantly lower than that of the normal control group(1.63±0.58vs1.74±0.56vs1.93±0.58vs2.09±0.59,×109L, P<0.01).(2)The expression levels of Fas in peripheral T lymphocytes were stronger than that of the normal controls(77.54±7.86vs66.67±10.16vs57.56±7.41vs46.54±6.63,%,P<0.01), especially in AMI group.(3) The expression of FasL(CD178+) can be detected in the surface of lymphocyte in the four groups,but the difference was not significant(P>0.05).(4) The levels of sFas in the four groups were different (9.79±2.03vs7.47±1.94vs4.99±1.55vs3.64±1.38,ng/mL, P<0.01), especially in AMI group.(5)The level of hsCRP in all patients with coronary heart disease was higher than that in the normal control group(8.09±1.94vs5.56±1.30vs3.62±1.74vs2.56±1.16, ng/mL,P<0.01).(6) There was a significantly positive correlations between Fas%and sFas and hsCRP (r=0.380,0.482, P<0.01); there also was a significant negative correlations between Fas%and lymphocyte absolute number (r=-0.486, P<0.01).Conclusion:(1) There exists apoptosis in peripheral blood lymphocytes in patients with coronary heart disease, the proportion of apoptosis is related to reduction of peripheral blood lymphocytes.(2)The expression ratio of Fas in Lymphocyte surface and the level of serum sFas has closely relationship with the severity of coronary artery disease; as an important factor of in apoptosis,Fas together with hsCRP can be used as a predictor in CHD.(3)The interaction between Fas/FasL system mediated apoptosis and inflammation take part in the occurrence and development process of atherosclerosis. |
