【摘要】 目的 探讨程序性细胞死亡因子-4(PDCD4)在非瓣膜性心房颤动(NVAF)患者外周血T淋巴细胞内的表达水平变化，以及PDCD4阳性T淋巴细胞内的细胞因子的表达能力。方法 选取2023年10月至2024年6月在新疆医科大学第一附属医院收治的NVAF患者70例为NVAF组，按照年龄、性别1∶1配比原则选取非心房颤动(AF)患者人群70例为对照组。收集两组研究对象体质指数(BMI)、吸烟史、饮酒史、冠心病史、2型糖尿病史、高血压史、高脂血症史、甲状腺功能亢进症史(甲亢)、慢性阻塞性肺疾病史(COPD)、阻塞性睡眠呼吸暂停病史；采集空腹肘静脉血5 mL,流式细胞术检测T淋巴细胞内PDCD4表达情况以及PDCD4阳性T淋巴细胞内细胞因子的表达情况。结果 两组间年龄、性别、BMI、吸烟史、饮酒史、冠心病史、2型糖尿病史、高血压史、高脂血症史、甲亢史、慢性阻塞性肺疾病史、阻塞性睡眠呼吸暂停病史比例比较，差异无统计学意义(均P>0.05)。NVAF组患者PDCD4基因在CD4~+ T、CD8~+ T细胞内表达水平显著高于对照组(均P<0.001)。NVAF组患者外周血PDCD4阳性群T细胞(CD3~+PDCD4~+)内白介素-4(IL-4)、白介素-17A(IL-17A)的表达水平显著高于PDCD4阴性群T细胞(CD3~+PDCD4~-)(P<0.05),CD3~+PDCD4~+ T细胞内干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)表达水平与CD3~+PDCD4~-T细胞群比较，差异无统计学意义(P>0.05)。结论 PDCD4在NVAF患者外周血CD4~+ T、CD8~+ T细胞内表达上调，并且外周血PDCD4阳性群T细胞内IL-4、IL-17A的表达水平高于PDCD4阴性群T细胞，提示PDCD4可能参与了T淋巴细胞介导的炎症反应，影响AF发生发展。更多还原

【Abstract】 Objective To investigate the expression of programmed cell death factor-4(PDCD4) in peripheral blood T lymphocytes of the patients with nonvalvular atrial fibrillation(NVAF), as well as the expression levels of PDCD4-positive T lymphocytes. Methods A total of 70 NVAF patients admitted to the hospital from October 2023 to June 2024 were selected for NVAF group. Additionally, 70 control subjects without atrial fibrillation(AF) were matched based on age and sex at a ratio of 1∶1. Data regarding body mass index(BMI), smoking history, alcohol consumption history, coronary heart disease history, type 2 diabetes history, hypertension history, hyperlipidemia history, hyperthyroidism history, chronic obstructive pulmonary disease(COPD) history and obstructive sleep apnea history were collected of both groups. 5 milliliters of fasting elbow venous blood was drawn to assess PDCD4 expression in T lymphocytes and cytokine levels in PDCD4-positive T lymphocytes using flow cytometry. Results No significant differences were observed between the 2 groups concerning age, sex, BMI, smoking history, drinking history, coronary heart disease history, type 2 diabetes history, hypertension history, hyperlipidemia history, nor regarding histories of hyperthyroidism or COPD and obstructive sleep apnea(all P>0.05). The expression level of the PDCD4 gene in CD4~+ T cells and CD8~+ T cells within the NVAF group was significantly higher than that found in control group(P<0.001). The levels of interleukin-4(IL-4) and interleukin-17A(IL-17A) in peripheral blood PDCD4-positive T cells(CD3~+PDCD4~+) from the NVAF group were significantly elevated compared to those in PDCD4-negative T cells(CD3~+PDCD4~-)(P<0.05). The expression of interferon-gamma(IFN-γ) and tumor necrosis factor-alpha(TNF-α) in CD3~+PDCD4~+ T cells was not statistically significant compared to the CD3~+PDCD4~- T cell population. Conclusion The upregulation of PDCD4 expression is the evident within peripheral blood CD4~+ T and CD8~+ T cells among the NVAF patients.Additionally, elevated IL-4 and IL-17A expressions are noted within peripheral blood CD3~+PDCD4~+ T cells when compared with their negative counterparts indicating a potential role for PDCD4 in mediating inflammation via T lymphocytes that may influence AF onset and progression.更多还原