缺血性脑卒中患者TLR2 TLR4与血小板神经功能的关系

Relationship between TLR2 TLR4 and platelet and neurological function in ischemic stroke patients

目的探究缺血性脑卒中患者外周血单核细胞(PBMC)中Toll样受体(TLR)2、TLR4表达水平与血小板活化及神经功能的关系。方法选取2017年5月至2020年6月邢台医学高等专科学校第二附属医院收治的134例缺血性脑卒中患者为研究对象(研究组),同期140例健康体检者为对照(对照组),收集两组对象一般资料。采用实时荧光定量PCR(RT-qPCR)检测两组对象PBMC中TLR2、TLR4 mRNA水平;利用酶联免疫吸附试验(ELISA)法检测两组对象血浆中血小板活化因子(PAF)、血小板活化标志物α颗粒膜糖蛋白140(GMP-140)、β-血小板球蛋白(β-TG)、血小板第4因子(PF4)水平;采用美国国立卫生院卒中量表(NIHSS)评分评估研究组患者神经功能;Spearman分析研究组患者PBMC中TLR2、TLR4与糖尿病史、高血压史的相关性;Pearson分析研究组患者PBMC中TLR2、TLR4与低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FBG)、高密度脂蛋白胆固醇(HDL-C)水平,血浆中PAF、GMP-140、β-TG、PF4水平,NIHSS评分的相关性。结果与对照组相比,研究组糖尿病史、高血压史比例,LDL-C、FBG水平,PBMC中TLR2、TLR4水平,血浆中PAF、GMP-140、β-TG、PF4水平升高(P<0.05),HDL-C水平降低(P<0.05)。研究组NIHSS评分为(14.59±7.48)分。相关性分析发现,PBMC中TLR2、TLR4与PAF、β-TG、PF4、NIHSS评分,TLR4与LDL-C、FBG、GMP-140呈正相关(P<0.05)。结论缺血性脑卒中患者PBMC中TLR2、TLR4表达水平升高,其与血小板活化及神经功能评分具有一定相关性。

Objective To explore the relationshipbetween the expression of Toll-like receptor(TLR)2 and TLR4 in peripheral blood mononuclear cells(PBMC)with platelet activation and neurological function in patients with ischemic stroke.Methods From May 2017 to June 2020,134 patients with ischemic stroke admitted to the Second Affiliated Hospital of Xingtai Medical College were selected as the study group;meanwhile,140 healthy people were gathered as the control group.The general data were collected.Real-time quantitative PCR(RT-qPCR)was performed to determine the levels of TLR2 and TLR4 mRNAs in PBMC of two groups.Enzyme linked immunosorbent assay(ELISA)was performed to measure the levels of platelet-activating factor(PAF),plateletα-granule membrane protein-140(GMP-140),β-thromboglobulin(β-TG)and platelet factor 4(PF4)in plasma.For patients with ischemic stroke,National Institute of Health Stroke Scale(NIHSS)was carried out to evaluate the neurological function;Spearman correlation analysis was carried out to analyze the correlation between TLR2 and TLR4 in PBMC with the histories of diabetes and hypertension.Pearson correlation analysis was performed to analyze the correlation between the levels of TLR2,TLR4 in PBMC with the levels of low density lipoproteincholesterol(LDL-C),fasting blood glucose(FBG),high density lipoprotein cholesterol(HDL-C),the levels of PAF,GMP-140,β-TG and PF4 in plasma,and NIHSS score.Results Compared with the control group,the proportions of diabetes history and hypertension history,the levels of LDL-C and FBG,the levels of TLR2 and TLR4 in PBMC,the levels of PAF,GMP-140,β-TG and PF4 in plasma in the study group increased(P<0.05),and the level of HDL-C decreased(P<0.05).The NIHSS score of the study group was(14.59±7.48)points.Correlation analysis showed that TLR2 and TLR4 in PBMC were positively correlated with PAF,β-TG,PF4 and NIHSS score,and TLR4 was positively correlated with LDL-C,FBG and GMP-140(P<0.05).Conclusions TLR2 and TLR4 are highly expressed in PBMC of patients with ischemic stroke,which are tightly related to platelet activation and neurological function score.