脑卒中患者外周血树突状细胞亚型数量变化的研究

Quantity Change of Peripheral Blood Dendritic Cells Subtypes in Patients with Stroke

目的研究脑卒中患者外周血中树突状细胞（DCs）的变化规律。方法选择2014年6-9月在北京博爱医院神经康复科住院的脑梗死患者30例和脑出血患者26例，依据美国国立卫生院神经功能缺损评分（NIHSS）标准评价脑卒中的严重程度。同时选择健康体检者14名作为正常对照组。采用流式细胞技术检测三组外周血中DCs各亚型的比例。结果三组间外周血中DCs的数量无统计学差异，但其亚型的比例具有明显变化。与对照组相比，脑出血和脑梗死患者骨髓样树突状细胞（mDCs）占外周血树突状细胞的比例均显著减少（P〈0．001）。脑出血患者外周血浆细胞样树突状细胞（pDCs）的比例下降（P〈0．05），脑梗死患者pDCs比例降低更加显著（P〈0．001）。根据NIHSS评分，脑出血和脑梗死患者分别分成NIHSS≤7组和NIHSS〉7组。脑出血和脑梗死患者NIHSS〉7组pDCs的比例均低于NIHSS≤7组（P〈0．05），但NIHSS〉7组mDCs比例与NIHSS≤7组无显著性差异。结论脑卒中患者外周血中DCs亚型的分布比例发生变化，提示免疫炎症反应在脑卒中发病过程中发挥作用。

Objective To explore the change of proportion of peripheral blood dendritic cells （DCs） in patients with stroke. Methods 56 patients （30 cases of cerebral infarction and 26 cases of cerebral hemorrhage） in Beijing Bo＇ai hospital from June to September, 2014 and 14 healthy controls were investigated. The severity of stroke was assessed with the National Institutes of Health Stroke Scale （NIHSS）. Flow cy- tometry analysis was employed to detect the proportion of DCs subtypes in the peripheral blood. Results No obvious difference was found in DCs between the stroke patients and the controls. Compared to the control group, the percentages of peripheral blood myeloid dendritic cells （mDCs） decreased in the cerebral hemorrhage and the cerebral infarction subgroups （P〈0.001）. The percentages of plasmacytoid den- dritic cells （pDCs） reduced significantly in the cerebral hemorrhage and the cerebral infarction subgroups （P〈0.05）. The stroke patients were divided into NIHSS ≤7 subgroup and NIHSS〉7 subgroup. The percentages of pDCs in the cerebral hemorrhage and the cerebral infarction patients were significantly lower in the NIHSS〉7 subgroup than in the NIHSS ~〈7 subgroup （P〈0.05）. While there was no statistical differ- ence between NIHSS ~〈7 subgroups and NIHSS〉7 subgroups in the percentages of mDCs in the cerebral hemorrhage and cerebral infarction patients. Conclusion The proportion of DCs subtypes in the peripheral blood in stroke patients changed significantly, indicating inflamma- tion responds play a role in stroke.