摘要
目的探讨外周血辅助性T细胞(Th)1/Th2细胞因子与急性缺血性脑卒中(AIS)患者脑功能损伤和卒中后认知功能障碍(PSCI)的关系。方法选取AIS患者125例(AIS组)和同时段65例健康人(对照组),AIS患者根据美国国立卫生研究院卒中量表(NIHSS)评分分为轻度脑功能损伤组(33例)、中度脑功能损伤组(74例)和重度脑功能损伤组(18例),根据6个月后是否发生PSCI分为PSCI组(52例)和非PSCI组(73例)。采用流式细胞术检测外周血Th1、Th2比例,酶联免疫吸附法检测血清干扰素-γ(IFN-γ)、白细胞介素(IL)-4。通过Spearman相关性分析AIS患者外周血Th1/Th2细胞因子与NIHSS评分的相关性,单因素和多因素Logistic回归分析AIS患者PSCI的影响因素。结果AIS组外周血Th1、IFN-γ、Th1/Th2水平高于对照组,外周血Th2、IL-4水平低于对照组(P均<0.05)。轻度脑功能损伤组、中度脑功能损伤组、重度脑功能损伤组外周血Th1、IFN-γ、Th1/Th2依次升高,外周血Th2、IL-4水平依次降低(P均<0.05)。AIS患者外周血Th1、IFN-γ、Th1/Th2与NIHSS评分呈正相关,Th2、IL-4与NIHSS评分呈负相关(P均<0.05)。PSCI组年龄大于非PSCI组,NIHSS评分和Th1、IFN-γ、Th1/Th2高于非PSCI组,Th2、IL-4水平低于非PSCI组(P均<0.05)。NIHSS评分增加、Th1升高、IFN-γ升高、Th1/Th2升高为AIS患者PSCI的独立危险因素,Th2升高、IL-4升高为独立保护因素(P均<0.05)。结论外周血Th1/Th2细胞因子与AIS患者脑功能损伤加重和PSCI发生密切相关。
Objective To investigate the relationships between peripheral blood T helper cell(Th)1/Th2 cytokines and cerebral function impairment and post-stroke cognitive impairment(PSCI)in patients with acute ischemic stroke(AIS).Methods Totally 125 patients with AIS(AIS group)and 65 healthy individuals in the same period(control group)were selected.The patients with AIS were divided into the mild cerebral function impairment group(33 cases),moderate cerebral function impairment group(74 cases),and severe cerebral function impairment group(18 cases)ac-cording to the score of national institutes of health stroke scale(NIHSS).According to whether PSCI occurred after 6 months,they were assigned into the PSCI group(52 cases)and non-PSCI group(73 cases).Flow cytometry was used to detect the ratio of Th1 and Th2 in peripheral blood,and ELISA was used to detect serum interferon-γ(IFN-γ)and inter-leukin(IL)-4 levels.The correlation between peripheral blood Th1/Th2 cytokines and NIHSS scores in patients with AIS was analyzed by Spearman's correlation,and the factors influencing PSCI in patients with AIS were analyzed by univariate and multivariate Logistic regression.Results Peripheral blood Th1,IFN-γ,and Th1/Th2 were higher in the AIS group than in the control group,and peripheral blood Th2 and IL-4 levels were lower than those in the control group(all P<0.05).Peripheral blood Th1,IFN-γ,and Th1/Th2 sequentially increased in the mild cerebral functional impairment group,moderate cerebral functional impairment group,and severe cerebral functional impairment group,and peripheral blood Th2 and IL-4 levels sequentially decreased(all P<0.05).Peripheral blood Th1,IFN-γ,and Th1/Th2 were posi-tively correlated with NIHSS scores in AIS patients,and Th2 and IL-4 were negatively correlated with NIHSS scores(all P<0.05).The PSCI group was older than the non-PSCI group,with higher NIHSS scores and Th1,IFN-γ,and Th1/Th2,and lower Th2 and IL-4 levels(all P<0.05).Increased NIHSS score,elevated Th1,elevated IFN-γ,and elevated Th1/Th2 were independent risk factors for PSCI in patients with AIS,and elevated Th2 and IL-4 were independent protective factors(all P<0.05).Conclusion Peripheral blood Th1/Th2 cytokines are closely associated with the exacerbation of brain functional impairment and the occurrence of PSCI in patients with AIS.
作者
闫秀娟
李博
李宝柱
YAN Xiujuan;LI Bo;LI Baozhu(Department of Neurology,Beijing Hepingli Hospital,Beijing 100013,China)
出处
《山东医药》
CAS
2024年第22期32-36,共5页
Shandong Medical Journal
基金
首都卫生发展科研专项项目(首发2020-4-2014)。
