不同类型的急性脑梗死患者辅助性T细胞及甲基CpG结合蛋白2表达水平变化及其临床意义

The levels of regulatory T cells and MeCP2 protein in patients with different types of acute stroke

目的探讨不同类型的急性脑梗死患者辅助性T细胞(CD4^(+)T cells, CD4^(+)T细胞)及甲基CpG结合蛋白2(Methyl-CpG-binding protein 2,MECP2)表达水平变化及其临床意义。方法选取本院2017年2月-2019年2月收治的急性脑梗死患者156例作为病例组,按照请奥加兰(Orgaran, ORG)治疗急性脑卒中临床研究(Trial of ORG 10172 in acute stroke treatment, TOAST)分型对病例组进行分组:A组(n=82)为大动脉粥样硬化组,B组(n=33)为心源性栓塞组,C组(n=41)为小动脉闭塞组;同期体检健康者155例作为对照组;检测156例病例组和155例体检健康者外周血中CD4^(+) T细胞、MeCP2表达水平。结果 A组CD4^(+) T细胞表达水平明显低于B组、C组以及对照组(P<0.05);B组CD4^(+) T细胞表达水平明显高于C组和对照组(P<0.05)。病例组MeCP2表达水平明显高于对照组(P<0.05);A组MeCP2表达水平明显高于B组、C组和对照组(P<0.05)。CD4^(+)细胞表达水平与A组呈负相关(B=-1.822,P<0.001)。结论不同急性脑梗死亚型中CD4^(+)T细胞表达水平不一样,对于大动脉粥样硬化型的脑梗死患者CD4^(+)T细胞表达水平下降,而MeCP2表达水平的升高也预示急性脑梗死的风险增大,说明CD4^(+)T细胞表达水平检测对于急性脑梗死的分型具有一定的意义,而MeCP2表达水平的变化可以作为预防急性脑梗死的重要指标。

Objective To explore the levels of regulatory T cells and methyl-CpG-binding protein 2(MeCP2) in patients with different types of acute stroke. Methods 156 patients with acute cerebral infarction between February 2017 to February 2019 were enrolled in this study. The patients were classified based on the TOAST(Trial of ORG 10172 in Acute Stroke Treatment) classification. Group A(n=82, large artery atherosclerosis), group B(n=33, cardiogenic embolism) and group C(n=41, small artery occlusion). 155 healthy subjects were enrolled as the control group. The number of CD4^(+) T cells and the expression levels MeCP2 in the peripheral blood were analyzed. Results The number CD4^(+) T cells in group A were significantly lower than those in group B, group C, and the control group(P<0.05);The number of CD4^(+) T cells in group B were significantly higher than those in group C and control group(P<0.05). The MeCP2 expression levels in stroke patients were significantly higher than the control subjects(P<0.05);the MeCP2 levels of group A were significantly higher than that of group B, group C, and the control group(P<0.05).Conclusion The number of CD4^(+) T cells and the levels of MeCP2 varies in different acute stroke subtypes. They may facilitate the classification of acute cerebral infarction.