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中华口腔医学研究杂志(电子版)

中华口腔医学研究杂志(电子版) ›› 2020, Vol. 14 ›› Issue (05) : 302 -307. doi: 10.3877/cma.j.issn.1674-1366.2020.05.005

所属专题： 文献；

临床研究

慢性牙周炎伴冠心病患者Th17/Treg细胞平衡的临床意义
向文静1, 何建华2, 董贝贝1, 陈晓涛3,†()   
  1. 1. 新疆医科大学口腔医学院，乌鲁木齐　830001
    2. 新疆乌鲁木齐市口腔医院检验科，乌鲁木齐　830002
    3. 新疆维吾尔自治区人民医院口腔科，乌鲁木齐　830000
  • 收稿日期:2020-02-23 出版日期:2020-10-01
  • 通信作者: 陈晓涛

The clinical significance of Th17/Treg cell balance in chronic periodontitis patients with coronary heart disease

Wenjing Xiang1, Jianhua He2, Beibei Dong1, Xiaotao Chen3,†()   

  1. 1. Department of Stomatology, Xinjiang Medical University, Urumqi 830001, China
    2. Department of Laboratory Medicine, Xinjiang Urumqi Stomatology Hospital, Urumqi 830002, China
    3. Department of Stomatology, People′s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, China
  • Received:2020-02-23 Published:2020-10-01
  • Corresponding author: Xiaotao Chen
  • About author:
    Corresponding author: Chen Xiaotao, Email:
  • Supported by:
    National Natural Science Foundation of China(81660185); Urumqi Science and Technology Project(G161310006)
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向文静, 何建华, 董贝贝, 陈晓涛. 慢性牙周炎伴冠心病患者Th17/Treg细胞平衡的临床意义[J]. 中华口腔医学研究杂志(电子版), 2020, 14(05): 302-307.

Wenjing Xiang, Jianhua He, Beibei Dong, Xiaotao Chen. The clinical significance of Th17/Treg cell balance in chronic periodontitis patients with coronary heart disease[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2020, 14(05): 302-307.

目的

探讨慢性牙周炎伴冠心病患者外周血中辅助性T细胞17（Th17）、调节性T细胞（Treg）及Th17/Treg细胞平衡表达水平及临床意义。

方法

本研究采用2 × 2析因设计，根据冠状动脉造影结果及牙周炎诊断标准，收集2019年3—12月就诊于新疆维吾尔自治区人民医院心内科及门诊口腔科患者113例研究对象，其中健康对照组28例、单纯慢性牙周炎组26例、单纯冠心病组27例和冠心病合并慢性牙周炎组32例。流式细胞术检测外周血Th17、Treg细胞比例，计算Th17/Treg细胞比值。采用方差分析比较各组细胞比例，2 × 2析因分析探讨牙周炎和冠心病对Th17/Treg细胞平衡的交互作用。

结果

与健康对照组、慢性牙周炎组及冠心病组相比，冠心病合并慢性牙周炎组Th17细胞比例[（1.4 ± 0.6）%]显著升高，差异有统计学意义（F = 18.40，P<0.001）。与健康对照组[（8.73 ± 2.70）%]相比，冠心病合并慢性牙周炎组Treg细胞比例[（6.26 ± 2.51）%]显著降低，差异有统计学意义（F = 6.29，P = 0.001）。Th17/Treg比值在牙周炎伴冠心病组[0.221（0.317）]与健康对照组[0.055（0.054）]和慢性牙周炎组[0.119（0.115）]比较显著升高，差异有统计学意义（χ2 = 40.25，P<0.001），存在Th17/Treg失衡；析因分析表明，牙周炎与冠心病对Treg细胞水平存在交互效应（F = 3.91，P = 0.041）。

结论

牙周炎伴冠心病患者存在Th17/Treg比例失衡，且向Th17细胞偏移，表明Th17/Treg细胞平衡可能参与牙周炎伴冠心病的发生、发展。

关键词: 慢性牙周炎, 冠状动脉疾病, 辅助性T细胞17, 免疫调节T淋巴细胞
Objective

To investigate the expression levels and clinical significance of peripheral blood helper t cells 17 (Th17) , regulatory t cells (Treg) and Th17/Treg cells in chronic periodontitis patients with coronary heart disease.

Methods

In this study, 2 × 2 factorial design was used. According to outcomes of coronary angiography and the diagnostic criteria of periodontitis, a total of 113 patients with cardiology and stomatology in Xinjiang Uygur Autonomous Region People′s Hospital from March to December 2019 were collected, including 28 healthy control group, 26 chronic periodontitis group, 27 coronary heart disease group and 32 coronary heart disease combined with chronic periodontitis group. The proportion of Th17 and Treg cells in peripheral blood was detected by flow cytometry, and the ratio of Th17/Treg cells was calculated. Variance analysis was used to compare the cell proportion of each group, and 2 × 2 factorial analysis was used to explore the interaction between periodontitis and coronary heart disease on Th17/Treg cell balance.

Results

The imbalance of Th17/Treg was found in the peripheral blood of the patients with coronary heart disease and chronic periodontitis. The proportion of circulating Thl7 cell level was significantly higher in coronary heart disease combined with chronic periodontitis group than in healthy control group, chronic periodontitis group and coronary heart disease group (F = 18.40, P<0.001) . The proportion of circulating Treg cell level was significantly higher in coronary heart disease combined with chronic periodontitis group than in healthy control group (F = 6.29, P = 0.001) .The ratio of Thl7/Treg was significantly higher in coronary heart disease combined with chronic periodontitis group than in healthy control group and chronic periodontitis group (χ2 = 40.25, P<0.001) . The factorial analysis demonstrated the effect of periodontitis on Treg cell level in patients with coronary heart disease (F = 3.91, P = 0.041) .

Conclusions

The imbalance of Th17/Treg ratio in patients with periodontitis and coronary heart disease and deviated to Th17 cells indicate that Th17/Treg cell balance may participate in the occurrence and development of periodontitis and coronary heart disease.

Key words: Chronic periodontitits, Coronary disease, Th17 cells, T-lymphocytes, regulatory
图1 流式细胞仪分析四组患者外周血Th17细胞比例
图2 流式细胞仪分析四组患者外周血Treg细胞比例
表1 各组外周血Th17、Treg细胞比例及Th17/Treg比值的统计学结果
组别 例数 Th17（%, ± s) Treg（%, ± s) Th17/Treg[中位数（四分位数间距）]
健康对照组 28 0.51 ± 0.24abc 8.73 ± 2.70 0.055(0.054)
慢性牙周炎组 26 0.82 ± 0.43cd 7.18 ± 2.85d 0.119(0.115)cd
冠心病组 27 1.02 ± 0.54cd 5.74 ± 3.04d 0.185(0.336)d
牙周炎伴冠心病组 32 1.4 ± 0.6abd 6.26 ± 2.51d 0.221(0.317)ad
检验值 ? F = 18.40 F = 6.29 χ2=40.25
P值 ? <0.001 <0.001 <0.001
图3 牙周炎和冠心病对于Th17/Treg细胞水平影响交互示意图　A：Th17细胞；B：Treg细胞
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