外周血T淋巴细胞亚群、CD147及VWF水平与短暂性脑缺血发作患者早期临床转归的关系

Relationship between peripheral blood T lymphocyte subsets,CD147 and VWF levels and early clinical outcome in patients with transient ischemic attack

目的研究外周血T淋巴细胞亚群、细胞外基质金属蛋白酶诱导子(CD147)及血管性血友病因子(VWF)水平对短暂性脑缺血发作(TIA)患者的临床意义。方法选择河北省沧州中西医结合医院2020年7月至2022年9月期间诊治的102例TIA患者作为实验组,根据卒中风险系数ABCD3⁃I评分表将TIA患者分为高危组、中危组、低危组,根据TIA患者发病72 h内是否发生脑梗死将患者分为脑梗死组(发生脑梗死)、无脑梗死组(未发生脑梗死),另选取98名健康志愿者作为对照组。分别比较实验组与对照组、不同危险程度TIA患者、不同早期临床转归TIA患者的外周血T淋巴细胞亚群、CD147及VWF水平;采用Spearman分析该些指标与TIA患者脑梗死发生率的相关性。结果实验组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)明显低于对照组,CD8^(+)、CD147、VWF水平明显高于对照组,差异有统计学意义(P<0.05);三组不同危险程度TIA患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)呈现:高危组<中危组<低危组,CD8^(+)、CD147、VWF水平呈现:高危组>中危组>低危组,差异有统计学意义(P<0.05);脑梗死组TIA患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)明显低于无脑梗死组,CD8^(+)、CD147、VWF水平显著高于无脑梗死组,差异有统计学意义(P<0.05);Spearman分析结果显示,TIA患者脑梗死发生率与CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)呈负相关,与CD8^(+)、CD147、VWF水平呈正相关(P<0.05)。结论外周血T淋巴细胞亚群、CD147及VWF水平与TIA患者早期临床转归有明显的关联,可作为TIA患者是否会发生脑梗死的重要评估指标。

Objective To study the clinical significance of peripheral blood T lymphocyte sub⁃sets,extracellular matrix metalloproteinase inducer(CD147)and von Willebrand factor(VWF)levels in pa⁃tients with transient ischemic attack(TIA).Methods 102 TIA patients diagnosed and treated in Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province from July 2020 to Septem⁃ber 2022 were selected as the experimental group for research,according to the stroke risk coefficient ABCD3⁃I scoring table,TIA patients were divided into the high⁃risk group,the intermediate⁃risk group and the low⁃risk group,and according to whether cerebral infarction occurs within 72 hours of TIA patients,patients were di⁃vided into the cerebral infarction group(cerebral infarction occurred)and the non⁃cerebral infarction group(cerebral infarction did not occur),and another 98 healthy volunteers were selected as the control group,and the peripheral blood T lymphocyte subsets,CD147 and VWF levels of the experimental group and the control group,TIA patients with different risk levels,and TIA patients with different early clinical outcomes were compared.Spearman was used to analyze the correlation between these indicators and the incidence of cerebral infarction in TIA patients.Results CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in the experimental group were significantly lower than those in the control group,and CD8^(+),CD147 and VWF levels in the experimental group were sig⁃nificantly higher than those in the control group,and the difference was statistically significant(P<0.05);CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in the three groups of TIA patients with different risk levels showed:high risk group<intermediate risk group<low risk group.CD8^(+),CD147 and VWF levels showed:high risk group>in⁃termediate risk group>low risk group,and the difference was statistically significant(P<0.05).CD3^(+),CD4^(+),CD4^(+)/CD8^(+)of TIA patients in the cerebral infarction group were significantly lower than those in the non⁃cerebral infarction group,the levels of CD8^(+),CD147 and VWF in the cerebral infarction group were sig⁃nificantly higher than those in the non⁃cerebral infarction group,and the difference was statistically significant(P<0.05).Spearman analysis showed that:the incidence of cerebral infarction in TIA patients was negatively correlated with CD3^(+),CD4^(+),CD4^(+)/CD8^(+),and positively correlated with CD8^(+),CD147 and VWF levels(P<0.05).Conclusion The levels of T lymphocyte subsets,CD147 and VWF in peripheral blood are signifi⁃cantly associated with the early clinical outcome of TIA patients,which can be used as important indicators for evaluating whether TIA patients will develop cerebral infarction.