急性动脉粥样硬化性脑梗死患者外周血CD4＋CD25＋调节性T细胞（Treg）水平的变化及临床意义

目的 测定急性动脉粥样硬化性脑梗死患者外周血CD4＋CD25＋调节性T细胞（Treg）的水平的变化,并探讨其临床意义.方法 收集2012年2-12月在吉林大学中日联谊医院神经内科住院的发病7天内的急性期动脉粥样硬化性脑梗死患者（即梗死组）48例和同期住院健康体检者（即对照组）30例外周血CD4＋CD25＋调节性T细胞（Treg）水平,分别记录梗死组患者神经功能缺损程度、梗死病灶体积以及颈动脉内-中膜厚度.结果 ①梗死组不同神经功能缺损程度患者外周血CD4＋CD25＋调节性T细胞（Treg）百分比均较对照组显著降低,差异有统计学意义（P＜0.05）;其中,重度组外周血CD4＋CD25＋调节性T细胞（Treg）百分比低于中度组,中度组外周血CD4＋CD25＋调节性T细胞（Treg）百分比低于轻度组,差异均有统计学意义（P＜0.05）.②梗死组不同梗死病灶体积患者外周血CD4＋CD25＋调节性T细胞（Treg）百分比均较对照组明显降低,差异有统计学意义（P＜0.05）;其中,大灶组外周血CD4＋CD25＋调节性T细胞（Treg）百分比低于中灶组,中灶组外周血CD4＋CD25＋调节性T细胞（Treg）百分比低于小灶组,差异均有统计学意义（P＜0.05）.③梗死组患者均经颈动脉血管超声证实有颈动脉粥样硬化（CAS）,根据病变程度分为三组：颈动脉内膜增厚组（A亚组）、颈动脉斑块组（B亚组）、颈动脉狭窄组（C亚组）,三组患者外周血CD4＋CD25＋调节性T细胞（Treg）百分比均较对照组降低.其中,C亚组外周血CD4＋CD25＋调节性T细胞（Treg）百分比低于B亚组,B亚组外周血CD4＋CD25＋调节性T细胞（Treg）百分比低于A亚组,差异均有统计学意义（P＜0.05）.结论 外周血CD4＋CD25＋调节性T细胞（Treg）水平在脑缺血急性期明显降低,与脑梗死后神经功能缺损程度、梗死灶体积、颈动脉粥样硬化程度有关.

Level changes and its clinical significance of peripheral blood CD4+CD25+ regulatory T cell(Treg)in patients with acute atherosclerotic cerebral infarction

Objective To determine the level of peripheral blood CD4＋ CD25＋ regulatory T cell（Treg）in patients with acute atherosclerotic cerebral infarction, and to explore its clinical significance, Methods The level of peripheral blood CD4＋ CD25＋ regulatory T cell（Treg）was determined by flow cytometry within 7 days of onset of patients with acute atherosclerotic cerebral infarction （infarction group,n= 48） and the same period healthy patients （control group, n = 30）. The neural function defect score,infarction lesion volume and carotid artery intima-media thickness （IMT） were determined？ in patients with acute atherosclerotic cerebral infarction. Results ①the percentage of peripheral blood CD4＋ CD25＋ regulatory T cell（Treg）with different degree of neurological deficit in infarction patients is significantly lower than the control group, the difference was statistically significant （P〈0.05） ; Among them, the heavy percentage of peripheral blood CD4＋ CD25＋ regulatory T cell（Treg）is lower than the moderate group,while the moderate percentage of peripheral blood CD4＋ CD25 ＋ regulatory T cell（Treg） is lower than the mild group, the difference was statistically significant （P〈0.05）. ②the percentage of peripheral blood CD4＋ CD25＋ regulatory T cell（Treg）with different infarct lesion volume in infarction patients is significantly lower than the control group, the difference was statistically significant （P〈0.05）; Among them,the stove percentage of peripheral blood CD4＋ CD25＋ regulatory T cell（Treg） group is lower than group in the kitchen, while the kitchen percentage of peripheral blood CD4＋ CD25＋ regulatory T cell（Treg） group is lower than the small focal group,the differences were statistically significant （P〈0.05）. ③A,B and C sub group patients the percentage of peripheral blood CD4＋ CD25＋ regulatory T cell（Treg） is lower than the control group. Where, the percentage of peripheral blood CD4 ＋ CD25 ＋ regulatory T cell（Treg） in C sub group is lower than the B sub-group, while the percentage of peripheral blood CD4＋ CD25＋ regulatory T cell（Treg） in B sub group is lower than the A sub-group,the differences were statistically significant （P（0.05）. Conclusion The level of periph- eral blood CD4＋ CD25＋ regulatory T eell（Treg）in patients with acute atheroselerotie cerebral infarction is reduced, it can become a sensitive and early indicator of cerebral infarction, and its level is related to neurologie impairment, infare tion size and the degree of carotid artery atherosclerosis.