Meta Analysis Of The Relationship Between Th1,Th2,Th17,Treg Cell Group And Coronary Heart Disease

Objective:To comprehensively evaluate the relationship between the dysfunction of CD4~+T lymphocyte subsets and in patients with coronary atherosclerotic heart disease(CHD),in order to provide evidence for clinical prevention and treatment of cardiovascular diseases.Methods:The computer search of Pub Med,Geen Medical,Cochrane Library,Wanfang Digital Journal Database and China National Knowledge Infrastructure(CNKI),were used to collect the published case-control studies on the imbalance of CD4~+T lymphocyte subsets and coronary heart disease at home and abroad,which were screened and evaluated independently by two researchers.The effect scale of measurement data was analyzed by standard mean deviation(SMD)and 95%confidence interval(CI),by Rev Man5.3software.Results:1.A total of 17 articles(all case-control studies)were selected for study,with a total of2535 subjects,of which 7 reported the change of Th1 cell proportion,5 reported the change of Th2 cell proportion,9 reported the change of Th17 cell proportion,5 reported the change of Treg cell proportion,and the proportion of CD4~+T lymphocyte subsets in peripheral blood of patients with different degrees of coronary heart disease was different;2.In the comparison of AMI,UA and control group,and AMI and SA,the SMD of Th1cells were significantly increased,respectively,[3.21(1.91,4.50)],[2.71(1.68,3.73)],[-3.04(-4.40,-1.68)].Compared with the control group,SA had no significant increase in SMD[0.25(-0.11,0.61)];3.There was no significant difference in Th2 cells between AMI,UA,SA and control group,and between AMI and SA,and the SMD was[0.08(-0.19,0.35)],[0.14(-0.13,0.40)],[0.26(-0.02,0.54)],[0.17(-0.11,0.45)],respectively;4.The proportion of Th17 cells in AMI,UA and control group and AMI and SA increased significantly,SMD was[3.51(2.52,4.50)],[3.59(2.65,4.54)],[-2.78(-3.51,-2.05)],SA had no significant increase in SMD compared with control group[1.07(0.50,1.65)];5.The proportion of Treg cells in AMI,UA and control group and between AMI and SA was significantly decreased,SMD was[-3.88(-5.07,-2.70)],[-2.95(-4.09,-1.82)],[3.46(2.41,4.50)],respectively.Compared with the control group,SA had no significant increase in SMD[-1.03(-1.59,-0.48)];6.Sensitivity analysis:in the comparison of stable angina pectoris between the Th1 cell group and the control group,the heterogeneity changed significantly after the removal of Shufang Han and Xiaobo Mao articles(I~2=8%,I~2=35%);7.Bias analysis:in the comparison of AMI and control group,UA and control group,SA and AMI group,the funnel pattern distribution of Th1 cells was relatively scattered,while that of SA and control group was relatively symmetrical;the distribution of Th17cells in the funnel map was relatively symmetrical,which was corresponding to the P value detected by Egger;there was publication bias in the study of Th1 cells.Conclusion:Immune dysfunction is closely related to the disease process of CHD.There is an imbalance in the proportion of CD4~+T lymphocyte subsets in patients with CHD,which is characterized by the overexpression of Th1 and Th17 cells in patients with acute myocardial infarction and unstable angina pectoris,while the expression of Treg cells is insufficient or suppressed.There was no significant difference in Th2 among the four groups.