摘要
目的研究体外循环对T淋巴细胞功能亚群分化及特异性转录因子T-bet、GATA结合蛋白3（GATA3）表达的影响。方法采用前瞻性双盲研究方法，选择2015年2月至2016年2月解放军第150中心医院收治的拟行体外循环下室间隔缺损修补术（观察组）和非体外循环下动脉导管结扎术（对照组）患者各20例，分别于术前、停机前或手术结束时、术后4 h、术后24 h取血，分离T淋巴细胞，采用RNA印迹法检测辅助性T细胞1（Th1）、细胞毒性T细胞（Tc1）特异性转录因子T-bet，Th2、Tc2特异性转录因子GATA3及细胞因子γ-干扰素（IFN-γ）、白细胞介素-4（IL-4）的mRNA表达。结果与术前相比，观察组体外循环停机前T-bet mRNA〔积分灰度值：（1.39±0.52）×105比（2.92±0.88）×105〕、IFN-γmRNA〔积分灰度值：（3.68±0.65）×105比（6.10±0.93）×105〕表达出现一过性下调（均P〈0.05），术后24 h基本恢复到术前水平〔积分灰度值分别为：（2.77±0.74）×105、（6.22±1.25）×105，均P〉0.05〕；GATA3 mRNA〔积分灰度值：（4.96±0.88）×105比（3.21±0.68）×105〕、IL-4 mRNA〔积分灰度值：（3.52±1.13）×105比（1.85±0.63）×105〕表达出现一过性上调（均P〈0.05），术后24 h基本恢复到术前水平〔积分灰度值分别为：（3.11±0.51）×105、（1.93±0.84）×105，均P〉0.05〕。对照组各时间点T-bet、GATA3、IFN-γ、IL-4的mRNA表达变化差异无统计学意义（均P〉0.05）。结论体外循环能够影响Th1、Tc1/Th2、Tc2细胞功能亚群分化及致炎、抗炎反应，可能参与了体外循环并发症的发生发展，而特异性转录因子T-bet/GATA3表达变化可能是其内在机制。
ObjectiveTo investigate the effects of cardiopulmonary bypass （CPB） on the differentiation of T lymphocyte subsets and the expression of specific transcription regulator T-bet/GATA binding protein 3 （GATA3）.MethodsA prospective double-blind study was conducted. Patients with CPB pulmonary repair of ventricular septal defect （observation group） or off-pump ligation of ductus arteriosus （control group） with 20 cases each in the 150th Military Hospital from February 2015 to February 2016 were enrolled. The blood sampled was collected on the time of before operation, at the end of CPB or operation, 4 hours after operation, and 24 hours after operation. T lymphocytes were isolated, the helper T cell 1 （Th1） specific transcription factor T-bet mRNA, helper T cell 2 （Th2） specific transcription factor GATA3 mRNA expression and cytokine γ-interferon （IFN-γ） mRNA, interleukin-4 （IL-4） mRNA expression were measured by Northern Blot.ResultsCompared with before operation, expression levels of T-bet mRNA [integral gray values： （1.39±0.52）×105 vs. （2.92±0.88）×105], IFN-γ mRNA [integral gray values： （3.68±0.65）×105 vs. （6.10±0.93）×105] were decreased transiently at the end of CPB in the observation group （both P 〈 0.05）, returned to preoperative levels at 24 hours after operation [integral gray values： （2.77±0.74）×105, （6.22±1.25）×105, respectively, both P 〉 0.05]; expression levels of GATA3 mRNA [integral gray values： （4.96±0.88）×105 vs. （3.21±0.68）×105], IL-4 mRNA [integral gray values： （3.52±1.13）×105 vs. （1.85±0.63）×105] were increased （both P 〈 0.05）, recovered to the preoperative levels at 24 hours after operation [integral gray values： （3.11±0.51）×105, （1.93±0.84）×105, respectively, both P 〉 0.05]. There were no significant differences in the expressions of T-bet, GATA3, IFN-γ and IL-4 mRNA in the control group at each time points （all P 〉 0.05）.ConclusionsCPB causes the imbalance of Th1, Tc1/Th2, Tc2 and pro-inflammatory and anti-inflammatory reactions specially, which participate the complication occurrence after CPB. The changing of T-bet/GATA3 may be the internal mechanism for these changes.
出处
《中华危重病急救医学》
CAS
CSCD
北大核心
2017年第12期1107-1111,共5页
Chinese Critical Care Medicine
基金
国家重点研发计划项目子课题（2016YFC1301403）
国家“十二五”科技支撑计划项目（2011BA111B19）
