目的：初步确定外周淋巴细胞和单核细胞是否参与了冠状动脉（冠脉）扩张(coronary artery ectasia, CAE)的病理过程,以推测CAE是否为免疫性疾病。方法：纳入2017年1月至2018年1月接受冠脉造影并确诊的34例CAE患者,利用抽签法纳入同日期接受冠脉造影的30例冠心病（coronary heart disease,CHD）患者和32例冠脉相对正常的受试者（对照组）。各组之间年龄、性别和其他基线特征基本平衡,通过流式细胞法检测外周血样中的淋巴细胞和单核细胞亚型。结果：CAE和CHD患者的外周血淋巴细胞亚型差异无统计学意义,但与CHD和对照组相比,CAE组的炎症型（非经典型）单核细胞比例显著增加[26.45%（16.90%~44.55%）,13.70%（9.33%~17.60%）,7.00%（13.70%~29.40%）,P=0.000],经典型单核细胞比例显著降低[66.35%（39.73%~78.83%）,82.90%（80.50%~89.40%）,78.30%（56.70%~83.80%）,P=0.000]。多重线性回归分析进一步证实了非经典单核细胞比例增加与CAE相关[定义CAE组=1,CHD组=2,对照组=3,故回归系数为负,即β=-0.371,P=0.000]。结论：CAE更可能是炎症性疾病,而不是免疫性疾病。

Objective To determine whether peripheral lymphocytes and monocytes were involved in the pathological processes of coronary artery ectasia (CAE). Methods This study included 34 patients who underwent coronary angiography and were diagnosed as CAE from January 2017 to January 2018. In addition, a total of 30 patients with coronary heart disease (CHD) and 32 subjects with relatively normal coronary arteries (control group) who underwent coronary angiography on the same period were included by lot. Three groups were balanced according to age, sex, and other baseline characteristics, and the lymphocyte and monocyte subtypes in their blood samples were examined via flow cytometry. Results Lymphocyte subtypes in CAE and CHD patients showed no significant differences. However, compared to the CHD and control groups, the inflammatory (non-classic type) monocytes were significantly increased [26.45% (16.90%-44.55%) vs 13.70%(9.33%-17.60%), or 7.00% (13.70%-29.40%), P=0.000], while the classic subtype monocytes were significantly decreased [66.35% (39.73%-78.83%) vs 82.90% (80.50%-89.40%) or 78.30% (56.70%-83.80%), P=0.000] in the CAE group. Multiple linear regression analysis further confirmed that the non-classic monocyte was related to CAE [CAE group=1, CHD group=2, control group=3, so the regression coefficient is negative as β=-0.371, P=0.000 ]. Conclusions CAE could be an inflammatory disease rather than an immune disease.