外周血Th17/Treg平衡与脑梗死的相关性研究

Research of the correlation between peripheral blood Th17/Treg balance and cerebral infarction

目的探讨外周血Th17/Treg平衡与脑梗死的相关性及临床价值。方法采用随机对照抽样方法,2013年2月至2017年1月选择在我院诊治的脑梗死患者122例作为梗死组。同期均在我院体检的健康者122例作为对照组。两组均进行外周血Th17/Treg细胞检测,同时进行白细胞介素(interleukin,IL)-17浓度检测与相关性分析。结果梗死组的Th17细胞百分比与IL-17浓度分别为(1.45±0.24)%和(58.20±22.19)ng/L,均高于对照组的(0.84±0.15)%和(21.00±11.93)ng/L(t值分别为10.648、11.285,P均<0.05)。梗死组的调节性T细胞(Treg)细胞比例为(4.89±0.81)%,低于对照组的(11.38±1.89)%(t=11.298,P<0.05)。Spearman秩相关法分析显示脑梗死患者的Treg细胞比例与Th17细胞比例、IL-17含量、神经功能缺损评分、梗死灶体积呈现明显负相关性(r值分别为-0.671、-0.385、-0.414、-0.533,P均<0.05)。多因素Logistic分析结果显示Th17细胞比例、IL-17含量、梗死灶体积为影响Treg细胞比例的主要因素[OR(95%CI)值分别为2.216(1.120~4.283)、2.062(1.109~3.298)、1.022(1.008~4.192),P均<0.05]。结论外周血Th17细胞和Treg细胞通过分泌相关的细胞因子,起到促炎和抗炎的作用,急性脑梗死患者外周血中Th17/Treg平衡参与了脑梗死后脑组织损伤过程。

Objective To investigate the correlation between Th 17/Treg balance in peripheral blood and cerebral infarction and its clinical value.Methods One hundred and twenty-two patients with cerebral infarction treated in affiliated Dongfeng Hospital of Hubei University of Medicine from February 2013 were randomly selected as the infarction group,and the other 122 healthy subjects for physical examination in Dongfeng Hospital at the same period were selected as the control group.The two groups were tested for peripheral blood Th 17/Treg cells,and the content of interleukin-17 was detected and the correlation was analyzed.Results The percentage of Th 17 cells and the levels of IL-17 in infarction group were(1.45±0.24)%and(58.20±22.19)ng/L,respectively,which were higher than those in the control gioup((0.84±0.15)%,(21.00±11.93)ng/L)(t=10.648,11.285,P<0.05).The proportion of Treg cells in the infarction group was(4.89±0.81)%,lower than that of the control group((11.38±1.89)%)(t=11.298,P<0.05).Spearman rank correlation analysis showed that the proportion of Treg cells in patients with cerebral infarction were negatively correlated with Th 17 cell ratio,IL-17 content,neurological deficit score and infarct volume(r=-0.671,-0.385,-0.414,-0.533,P<0.05).Multivariate logistic analysis showed that the percentage of Th 17,IL-17 content and infarct volume were the main influencing factors of Treg cells(OR(95%CI)=2.216(1.120-4.283),2.062(1.109-3.298),1.022(1.008-4.192),P<0.05).Conclusion Peripheral blood Th 17 cells and Treg cells have the proinflammatory and antiinflammatory effects by secreting cytokines in patients with acute cerebral infarction.Thl7/Treg balanee in peripheral blood of patients with acute cerebral infarction is involved in the process of brain tissue damage after cerebral infarction.