急性脑梗死患者外周血髓源抑制性细胞比例与预后的关系

Relationship between myeloid-derived suppressor cells proportion in peripheral blood and prognosis in peripheral blood patients with acute ischemic stroke

目的:探讨髓源抑制性细胞(MDSC)与急性脑梗死预后的关系。方法:采集128例急性脑梗死患者以及100例健康对照外周血进行流式细胞学检测并分析MDSC的比例。用改良Rankin评分评价急性脑梗死患者随访90 d的预后(0~2分为预后好,3~5分为预后差)。分析预后好组(n=51)与预后差组(n=77)临床参数之间的差异,采用logistic回归分析影响急性脑梗死预后的因素,采用ROC曲线评价患者外周血MDSC比例对患者预后的预测价值。结果:与健康对照组比较,急性脑梗死组外周血中多形核MDSC(PMN-MDSC)以及单核MDSC(M-MDSC)的比例上调(P<0.05)。与预后差组相比,预后好组急性脑梗死患者外周血中PMN-MDSC以及M-MDSC的比例上调(P<0.05)。PMN-MDSC与M-MDSC比例是影响急性脑梗死患者预后的危险因素。PMN-MDSC比例预测急性脑梗死患者预后的AUC为0.619(95%CI为0.519~0.720),截断值是4.220,敏感度为0.588,特异度为0.636;M-MDSC比例的AUC为0.747(95%CI为0.661~0.833),截断值是1.410,敏感度为0.784,特异度为0.623。结论:MDSC比例在急性脑梗死患者外周血中增加,并且可以作为患者的预后判断指标。

Aim:To investigate the relationship between myeloid-derived suppressor cell(MDSC)and the prognosis in patients with acute ischemic stroke.Methods:Flow cytometry was performed on 128 patients with acute ischemic stroke and 100 healthy controls to investigate the difference in the proportion of MDSC.Prognosis was evaluated using modified Rankin scale after 90 days of follow-up(0 to 2 scores means good recovery,while 3 to 5 scores means poor recovery).The difference between patients with good recovery(n=51)and poor recovery(n=77)was analyzed.Logistic regression analysis was used to search the factors that affected the prognosis of acute ischemic stroke.ROC curve was used to evaluate the prognostic value of the peripheral blood MDSC proportion.Results:Compared with healthy control group,the proportions of polymorphonuclear MDSC(PMN-MDSC)and monocytic MDSC(M-MDSC)in peripheral blood of patients in acute ischemic stroke group all increased(P<0.05).Compared with the group of patients with poor recovery,the proportions of PMN-MDSC and M-MDSC in peripheral blood of patients with good recovery increased(P<0.05).The PMN-MDSC and M-MDSC proportions were risk factors for prognosis of acute ischemic stroke patients.The AUC of the PMN-MDSC proportion was 0.619(95%CI was 0.519-0.720)when the cut-off was 4.220,the sensitivity was 0.588 and the specificity was 0.636.The AUC of M-MDSC proportion was 0.747(95%CI was 0.661-0.833)when the cut-off was 1.410,the sensitivity was 0.784 and the specificity was 0.623.Conclusion:MDSC proportion increases in peripheral blood of patients with acute ischemic stroke,and is related to the prognosis.