T淋巴细胞亚群在大脑半球大面积梗死患者中的表达及其对预后的判断价值

Expression of T lymphocyte subsets in patients with large hemispheric infarction and its value for judging prognosis

目的探讨T淋巴细胞亚群在颅内半球大面积梗死患者中的表达及其与病情转归的相关性。方法选择2015年3月至2019年3月该院收治的60例大脑半球大面积梗死患者作为研究组,分为预后良好组(21例)和预后不良组(39例),48例体检健康者作为对照组。检测外周血中CD3^+、CD4^+、CD8^+、CD4^+/CD8^+、各项生化指标,并进行格拉斯昏迷评分量表(GCS)及改良Rankin量表(mRS)评分,对研究组T淋巴细胞亚群与mRS评分进行相关分析,并分析其对预后评估的价值。结果研究组CD3^+、CD4^+及CD4^+/CD8^+低于对照组,CD8^+高于对照组,差异有统计学意义(P<0.05)。预后良好组与预后不良组在有无高血压史、高脂血症史,年龄,GCS、mRS评分,CD3^+、CD4^+、CD8^+、CD4^+/CD8^+、总胆固醇、低密度脂蛋白、血尿素氮、血肌酐及同型半胱氨酸水平上比较,差异有统计学意义(P<0.05)。CD3^+、CD4^+及CD4^+/CD8^+与mRS评分呈负相关(r=-0.698、-0.862、-0.813,P<0.001),CD8^+与mRS评分呈正相关(r=0.805,P<0.001)。结论CD3^+、CD4^+及CD8^+可能与大脑半球大面积梗死的发生、发展有关,其中CD4^+/CD8^+有可能成为指导临床治疗及预后评估的指标。

Objective To investigate the expression of T lymphocyte subsets in patients with large hemispheric infarction and its correlation with prognosis.Methods A total of 60 cases with large hemispheric infraction were recruited into study group from March 2015 to March 2019,and further divided into two subgroups,including good prognosis group(21 cases)and poor prognosis group(39 cases),meanwhile other 48 cases of health physical examinees were recruited into control group.T lymphocyte subsets including CD3^+,CD4^+,CD8^+,CD4^+/CD8^+,biochemical indexes,GCS score,mRS score were compared between different groups.The correlation of the T lymphocyte subsets and mRS score was analyzed,then the prognostic value of T lymphocyte subsets was determined.Results The proportions of CD3^+,CD4^+and CD4^+/CD8^+in study group were lower than those in control group,and the proportion of CD8^+was higher than that in control group(P<0.05).The proportion of hypertension history,hyperlipidemia history,age,GCS score,mRS score,the levels of CD3^+,CD4^+,CD8^+,CD4^+/CD8^+,total cholesterol,low-density lipoprotein,blood urea nitrogen,serum creatinine and homocysteine showed significant difference among patients with different prognosis(P<0.05).mRS score correlated negatively with the levels of CD3^+,CD4^+and CD4^+/CD8^+(r=-0.698,-0.862,-0.813,P<0.001),while correlated positively with CD8^+(r=0.805,P<0.001).Conclusion T lymphocyte subsets including CD3^+,CD4^+and CD8^+may correlate to the incidence of large hemispheric infraction,moreover,the CD4^+/CD8^+could be used as an indicator of the treatment guidance and prognosis evaluation.