急性脑梗死后脾脏体积变化与血清炎性因子、T淋巴细胞的相关性研究

Correlation of spleen volume change with serum inflammatory factors and T lymphocytes after acute cerebral infarction

目的观察急性脑梗死(ACI)后患者脾脏体积变化,并探讨其与血清炎性因子、T淋巴细胞的相关性。方法 2016年5月-2018年2月,选取病程在24 h内来榆林市第一医院神经内科接受住院治疗的ACI患者80例作为研究对象,于发病后24h内、2d、3d和5d检测脾脏体积、血清核因子κB (NF-κB)和T淋巴细胞亚群水平。同时选择同期基本资料与ACI组患者匹配的非ACI患者45例作为对照,于入院时检测上述指标作为基线。采用Pearson分析各个时间点脾脏体积和NF-κB、T淋巴细胞亚群的相关性。结果 ACI患者脾脏体积先缩小后增大,与对照组相比,ACI患者在发病24h内和2d脾脏体积会出现明显的缩小,且2d脾脏体积明显小于24h内脾脏体积,差异有统计学意义(P<0.05)。与对照组相比,3d和5d脾脏体积明显增大,且5d脾脏体积明显大于3d脾脏体积,差异有统计学意义(P<0.05)。与对照组相比,ACI患者在发病24h内、2d、3d和5d时CD3淋巴细胞、CD4淋巴细胞和NF-κB水平明显升高,差异具有统计学意义(P<0.05),其中发病2d水平明显高于发病24h内,差异有统计学意义(P<0.05),发病3d后出现下降,发病5d下降更为明显,差异均有统计学意义(P<0.05)。CD8淋巴细胞不同时间点有升高趋势,但变化差异无统计学意义(P>0.05)。相关性分析显示,ACI患者在发病24h内、2d、3d和5d时,CD3、CD4淋巴细胞和NF-κB与脾脏体积呈明显的负相关关系。不同时间点CD8淋巴细胞和脾脏体积无相关性。结论 ACI后患者脾脏可能通过释放炎性因子和CD3、CD4淋巴细胞加剧了缺血性脑损伤。

Objective To observe the change of spleen volume after acute cerebral infarction(ACI),and to explore the correlation with serum inflammatory factors and T lymphocytes.Methods From May 2016 to February2018,total 80 patients with ACI who were admitted to our hospital for treatment within 24 hours were selected as the study subjects.The spleen volume,serum level of NF-κB and T lymphocyte subsets were detected within 24 hours,2 d,3 d and5 d after the onset of the disease.At the same time,45 patients with non-ACI who were matched with the basic data of the same period and those in the cerebral infarction group were selected as the control group,and the above indexes were detected at the time of admission as the baseline.The correlation between spleen volume and NF-κB and T lymphocyte subsets was analyzed by Pearson.Results The spleen volume of patients with ACI first decreased and then increased.Compared with the control group,the spleen volume of patients with ACI significantly decreased within 24 h and 2 d,and the spleen volume in 2 d was significantly smaller than the patients with ACI within 24 h,the difference was statistically significant(P<0.05).Compared with the control group,the spleen volume on 3 d and 5 d increased significantly,and the spleen volume on 5 d was significantly larger than that on 3 d,the difference was statistically significant(P<0.05).Compared with control group,the CD3 lymphocytes,CD4 lymphocytes and NF-kappa B level increased significantly in patients with ACI incidence within 24 h,2 d,3 d and 5 d,the difference was statistically significant(P<0.05),and the 24 h levels were significantly high than 2,after 3 days of onset,there was a decrease,especially after 5 days of onset,the differences were statistically significant(P<0.05).CD8 lymphocytes showed an increasing trend at different time points,but the change was not statistically significant(P>0.05).Correlation analysis showed that CD3,CD4 lymphocytes and NF-κB were negatively correlated with spleen volume at 24 h,2 d,3 d and 5 d.There was no correlation between CD8 lymphocytes and spleen volume at different time points.Conclusion After ACI,the spleen may aggravate ischemic brain injury by releasing inflammatory factors and CD3 and CD4 lymphocytes.