三七总皂苷对急性脑梗死患者单核细胞CD14及TLR4的影响

Influence of total saponins panax notoginseng on CD14 and TLR4 of mononuclear cell in acute cerebral infarct patients

目的探讨三七总皂苷(PNS)对急性脑梗死患者单核细胞CD14及TLR4的影响。方法将67例发病3 d以内,符合试验入选标准的脑梗死患者随机分为实验组(n=33)和对照组(n=34),2组患者均常规应用相同的脱水剂和神经细胞活化剂,其中实验组以PNS 450mg/d静脉滴注,连续14 d。分别对所有患者入院时和入院后第3,7和14天采集外周血,以流式细胞术检测单核细胞膜上CD14及TLR4的表达变化,并对入院后第1天和第14天进行神经功能缺损评分和意识障碍评分,比较2组患者住院时间和住院费用。结果入院后第3天,实验组CD14及TLR4的表达明显低于对照组(P<0.05),第7天以后2组比较无显著性差异(P>0.05);与对照组比较,实验组入院后14 d神经功能缺损评分明显降低(P<0.05),而意识障碍评分则明显增高(P<0.05)。实验组住院时间和住院费用明显少于对照组(P<0.05)。结论PNS通过调节单核细胞CD14及TLR4的表达,减少炎性递质的释放,促进受损组织细胞的功能恢复,对急性脑梗死患者的康复有确切的疗效,还可通过减少患者的住院时间达到降低住院费用的目的。

Objective It is to discuss the influence of total saponins panax notoginseng （PNS） on CD14 and TLR4 of mononuclear cell in acute cerebral infarct patients. Methods Sixty-seven acute cerebral infarct patients were randomly divided into experiment group （ n = 33） and control group （ n = 34）. The two groups were treated with the regular therapy. The experiment group was added PNS 450 mg intravenous drip continuous 14 d, On admission and at the third day, the seventh day and the fourteenth day after admission, peripheral blood was taken for testing the levels of CD14 and TLR4 with flow cytometry. Neurologic impairment score and conscious disturbance score were done at the first day and the fourteenth day after admission. The in hospital times and in hospital costs of the two groups were compared. Results The expressions of CD14 and TLR4 in experiment group were significant lower than that in control group at the third day after admission （P 〈 0.05 ） and there was no significant difference between the two groups after the seventh day after admission （P〉 0.05 ）. Compared with control group, neurologic impairment score in experiment group obviously lowered （P 〈 0.05 ） and conscious disturbance score obviously heightened （ P 〈 0.05）. In hospital time and in hospital cost of experiment group were obviously fewer than that in control group （ P 〈 0.05 ）. Conclusion Through adjusting the expressions of CD14 and TLR4 of mononuclear cell, decreasing release of inflammatory transmitter and advancing the functional rehabilitation of the impaired tissue cell, PNS has exact curative effect on the rehabilitation of acute cerebral infarct patient and can achieve the objective of lowering the in hospital cost through decreasing the in hospital time.