阿托伐他汀对脑血管疾病介入治疗围手术期患者CD4^+T淋巴细胞PTEN表达的影响

Expression of PTEN in CD4^+T lymphocyte of patients with ischemic cerebrovascular disease

目的探讨老年缺血性脑血管疾病患者介入治疗围手术期CD4^+T淋巴细胞人第10号染色体缺失的磷酸酶张力蛋白同源基因(PTEN)表达的变化情况。方法选取2016年1月—2017年12月沈阳市第二中医医院收治的择期行介入手术治疗的80例老年缺血性脑血管疾病患者为研究对象,随机分为观察组和对照组,每组40例。观察组围手术期使用阿托伐他汀,对照组不使用阿托伐他汀,两组均于手术前后16～24 h抽取外周血20 ml。采用免疫磁珠法分选出CD4^+T淋巴细胞,Western blotting检测PTEN蛋白的表达,实时荧光定量聚合酶链反应(qRT-PCR)检测PTEN mRNA表达,酶联免疫吸附试验(ELISA)检测介入手术前后白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)的情况。结果观察组术后的PTEN mRNA、PTEN蛋白表达水平高于术前(P<0.05);对照组手术前后的PTEN mRNA及蛋白的表达水平比较差异无统计学意义(P>0.05);观察组术后的TNF-α低于术前,IL-10高于术前(P<0.05);对照组手术前后TNF-α、IL-10的差异无统计学意义(P>0.05)。相关性分析显示,IL-10与PTEN表达呈正相关,TNF-α与PTEN表达呈负相关(P <0.05)。结论介入手术后缺血性脑血管疾病患者存在炎症反应,而服用阿托伐他汀可降低这种炎症反应,其作用机制可能与阿托伐他汀可上调PTEN的表达有关。

Objective To investigate the expression of PTEN in CD4^+ T of elderly patients with ischemic cerebrovascular disease during perioperative period of interventive therapy. Methods A total of 80 patients with senile ischemic encephalopathy who were admitted to our hospital from January 2016 to December 2017 for interventional surgery were selected as the study subjects. They were randomly divided into observation group and control group (n = 40). All the patients received standard treatments while patients in observation group received additional Atorvastatin. 20 ml peripheral blood was extracted before and after the surgery. CD4^+ T lymphocytes were separated by immunomagnetic beads. PTEN expression was detected by Western blotting and fluorescence quantitative PCR. Levels of interleukin 10 (IL-10) and tumor necrosis factor α(TNF-α) were detected by ELISA prior to and post intervention. Results In observation group, postoperative expression of PTEN were higher than that before surgery (P < 0.05). No obvious difference in PTEN prior to and post interventive procedure was witnessed in the control group (P > 0.05). In the observation group, levels of TNF-α decreased while IL-10 increased after surgery compared with those before surgery (P < 0.05). In the control group, there was no significant difference in TNF-α and IL-10 before and after surgery (P > 0.05). Correlation analysis showed that IL-10 was positively correlated with PTEN expression while TNF-α was negatively correlated with PTEN expression (P < 0.05). Conclusions Interventive surgery induced inflammatory response may be down-regulated with oral intake of Atorvastatin in elderly patients with ischemic cerebrovascular disease;anti-inflammatory effect of Atorvastatin may be achieved through upregulatioin of PTEN.