刘洁.外周血辅助性T细胞17、调节性T细胞水平及其比值变化可评估急性脑出血患者外周炎性反应程度[J].内科急危重症杂志,2023,29(1):37-40
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| DOI：10.11768/nkjwzzzz20230110 |
| 中文关键词: 脑出血 辅助性T细胞17 调节性T细胞 辅助性T细胞17/调节性T细胞 |
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| 中文摘要: |
| 摘要 目的：观察急性脑出血(ICH)患者外周血辅助性T细胞17(Th17)和调节性T细胞(Treg)的表达及Th17/Treg比值的动态变化过程，并探讨其临床意义。方法：选取40例急性ICH患者为实验组，选取40例同期健康体检者为对照组。入院后行美国国立卫生研究院卒中量表(NIHSS)评分，依据头部CT影像估算血肿体积并按出血部位分为脑叶组18例和基底节组22例，于住院第1、4、7天分别检测外周血中Th17及Treg占CD4+T细胞的比例，并计算Th17/Treg比值，分析其在ICH后的动态演变过程，并探讨Th17、Treg及Th17/Treg与疾病严重程度、病灶出血位置的关系。结果：ICH组第1、4天外周血Th17比例逐渐降低，且高于对照组(P均<0.05)，第7天与对照组比较，差异无统计学意义(P>0.05)。外周血Treg比例在第1天明显低于对照组(P<0.05)，第4天Treg比例恢复至对照组水平(P>0.05)；第7天Treg比例虽有持续增长之势，但与对照组比较，差异无统计学意义(P>0.05)。外周血Th17/Treg比值在第1、4天高于对照组(P均<0.05)，第7天恢复至对照组水平(P>0.05)。第1天外周血Th17比例及Th17/Treg分别与入院NIHSS评分呈正相关(r=0.496、0.581，P均<0.05)，与出血体积也呈正相关(r=0.378、0.500，P均<0.05)，Treg比例与NIHSS评分、出血体积呈负相关(r=-0.377、-0.357，P均<0.05)。在不同病灶出血位置分组(脑叶出血组和基底节出血组)之间Th17、Treg比例及Th17/Treg均没有明显统计学差异(P>0.05)。结论：外周血Th17、Treg比例和Th17/Treg的演变可以用于评估ICH后外周炎性反应；且其与出血体积和神经功能缺损密切相关，可能与出血位置无关。 |
| 英文摘要: |
| Abstract Objective: To explore dynamic variation and significance of peripheral blood T helper cell 17 (Th17), regulatory T cells (Treg) and the ratio of Th17/Treg in patients with acute intracranial hemorrhage (ICH). Methods: A total of 40 patients with ICH were assigned as the case group, and 40 physical examinees at the same time were selected as the control group. National Institute of Health stroke scale (NIHSS) scores were evaluated on admission. Based on hematoma volume and its locus through CT images, 40 patients were divided into lobar hemorrhage group (n=18) and basal ganglia hemorrhage group (n=22). On the 1st, 4th, and 7th day after hospitalization, the proportions of Th17 and Treg in CD4+ T cells in peripheral blood were detected and their ratios were calculated. The dynamic variation was investigated. In addition, The correlations between Th17, Treg and Th17/Treg and severity of ICH and locus of hemorrhage were analyzed, respectively. Results: On the 1st and 4th day, the proportion of Th17 in ICH group gradually decreased but was still higher than that in control group (P<0.05). On the 7th day, there was no statistically significant difference between ICH group and control group (P> 0.05). The proportion of Treg in ICH group was significantly lower than that in the control group on day 1 (P< 0.05). There was no significant difference in the proportion of Treg between two group groups on the day 4 and 7 (P> 0.05). The Th17/Treg ratio on the 1st and 4th day in ICH group was significantly higher than in control group (P<0.05), and it went down to control group (P> 0.05) on the day 7. The expression of Th17 and Th17/Treg ratio on the day 1 in case group were positively correlated with the NIHSS score (r= 0.496, 0.581, P< 0.05), and also positively correlated with the hematoma volume (r= 0.378, 0.500, P< 0.05). The proportion of Treg was negatively correlated with NIHSS score and hematoma volume (r= 0.377, 0.357, P< 0.05). There was no significant difference in Th17, Treg and Th17/Treg between lobar hemorrhage group and basal ganglia hemorrhage group (P> 0.05). Conclusion: Variation of Th17, Treg and Th17/Treg ratio in peripheral blood can be used to evaluate peripheral inflammatory response after ICH, which may be closely related to hematoma volume and neurological deficit, and is less likely to associate with locus of hemorrhage. |
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