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目的观察急性脑梗死(ACI)患者外周血辅助性T细胞17(Th17)和调节性T细胞(Treg)表达及其比值(Th17/Treg)的变化,并探讨临床意义。方法 72例ACI患者,48例同期健康体检者为正常对照组,采用流式细胞术检测各组外周血中Th17及Treg占CD4+T细胞比例。ACI患者按照美国国立卫生研究院卒中量表(NIHSS)分为轻型组、中型组和重型组3种不同神经功能缺损程度,根据Pullicino公式分为小梗死灶组、中梗死灶组、大梗死灶组3种不同梗死灶类型。同时分析Th17、Treg比例及Th17/Treg比值分别与NIHSS评分、梗死灶体积的相关性。结果 ACI组患者Th17比例(7.26%±1.92%)、Th17/Treg比值(2.38±1.80)均显著高于与对照组(2.86%±0.65%,P<0.05;0.35±0.07,P<0.05),Treg比例(4.29%±1.82%)显著低于对照组(8.03%±1.10%,P<0.05)。ACI患者Th17比例和Th17/Treg比值及Treg比例在不同神经功能缺损程度和不同梗死灶类型中差异均有统计学意义(均P<0.05)。Th17/Treg比值分别与NIHSS评分、梗死灶体积呈正相关(r=0.865,0.672,P<0.05)。结论 ACI患者外周血Th17、Treg比例和Th17/Treg比值与急性脑梗死的严重程度密切相关,同时监测Th17/Treg比值的变化对评估患者的疾病进展具有一定临床参考意义。
Objective To observe the changes of Th17 and Th17 / Treg in peripheral blood of patients with acute cerebral infarction (ACI) and to explore the clinical significance. Methods 72 cases of ACI patients, 48 cases of healthy subjects at the same period as the normal control group, using flow cytometry in each group of peripheral blood Th17 and Treg CD4 CD4 T cell ratio. According to the National Institutes of Health Stroke Scale (NIHSS), ACI patients were divided into three groups according to the Pullicino formula: small infarction group, middle infarction group, large infarction group Group 3 different types of infarction. At the same time, the correlation between Th17, Treg ratio and Th17 / Treg ratio and NIHSS score and infarct volume were analyzed. Results The Th17 ratio (7.26% ± 1.92%) and Th17 / Treg ratio (2.38 ± 1.80) in ACI group were significantly higher than those in control group (2.86% ± 0.65%, P <0.05; 0.35 ± 0.07, Treg ratio (4.29% ± 1.82%) was significantly lower than that of the control group (8.03% ± 1.10%, P <0.05). There were significant differences in Th17 ratio, Th17 / Treg ratio and Treg ratio in different degree of neurological deficits and different infarct types (all P <0.05). Th17 / Treg ratio was positively correlated with NIHSS score and infarct volume (r = 0.865,0.672, P <0.05). Conclusion The ratio of Th17, Treg and Th17 / Treg in peripheral blood of ACI patients is closely related to the severity of acute cerebral infarction. To monitor the changes of Th17 / Treg ratio is of clinical significance for evaluating the disease progression in patients.