急性脑梗死患者入院时Hcy、HMGB1、TLR4水平与单核巨噬细胞极化的相关性  

Correlation between Hcy,HMGB1 and TLR4 levels at admission with monocyte macrophage polarization in patients with acute cerebral infarction

作　　者：王亮亮[1] 韩若东 张亚飞[1] 吴国柱 徐彦龙 WANG Liangliang;HAN Ruodong;ZHANG Yafei;WU Guozhu;XU Yanlong(Department of Critical Care Medicine,Affiliated Bozhou Hospital,Anhui Medical University,Bozhou,Anhui 236800,China)

机构地区：[1]安徽医科大学附属亳州医院重症医学科,安徽亳州236800

出　　处：《检验医学与临床》2024年第14期1996-2000,共5页Laboratory Medicine and Clinic

基　　金：国家自然科学基金项目(81974564);安徽省高校自然科学研究重点项目(2022AH050688)。

摘　　要：目的探讨急性脑梗死(ACI)患者入院时同型半胱氨酸(Hcy)、高迁移率族蛋白B1(HMGB1)、Toll样受体4(TLR4)水平与单核巨噬细胞极化的相关性。方法选择2020年8月至2022年8月该院收治的107例ACI患者为病例组,另选取同期体检健康者50例为对照组,比较2组入院时血清Hcy、HMGB1、TLR4水平,比较2组单核巨噬细胞极化情况[M1型细胞比例、M2型细胞比例、M1/M2比值、M1型极化标志物(白细胞介素-1β、肿瘤坏死因子-α)、M2型极化标志物(白细胞介素-10、转化生长因子-β)],分析ACI患者Hcy、HMGB1、TLR4水平与单核巨噬细胞极化的关系,分析ACI患者Hcy、HMGB1、TLR4水平与ACI患者预后的关系。根据ACI患者预后情况,将患者分为预后良好组和预后不良组,比较其血清Hcy、HMGB1、TLR4水平。通过受试者工作特征(ROC)曲线分析Hcy、HMGB1、TLR4对ACI预后的预测效能。结果与对照组比较,病例组血清Hcy、HMGB1、TLR4水平明显升高(P<0.05)。与对照组比较,病例组M1型细胞比例、M1/M2比值、白细胞介素-1β、肿瘤坏死因子-α水平明显升高(P<0.05),白细胞介素-10、转化生长因子-β水平明显降低(P<0.05)。Pearson相关分析结果显示,ACI患者血清Hcy、HMGB1、TLR4水平与M1型细胞比例、M1/M2比值、白细胞介素-1β和肿瘤坏死因子-α水平呈正相关(P<0.05),与白细胞介素-10、转化生长因子-β水平呈负相关(P<0.05)。与预后良好组比较,预后不良组血清Hcy、HMGB1、TLR4水平明显升高(P<0.05)。ROC曲线分析结果显示,Hcy、HMGB1、TLR4联合预测ACI预后的效能较高,其曲线下面积、灵敏度、特异度依次为0.840、77.80%、80.00%。结论Hcy、HMGB1、TLR4在ACI患者外周血中呈高表达,其水平与单核巨噬细胞极化及预后关系密切,有望成为ACI临床诊治的生物标志物。Objective To investigate the correlation between homocysteine(Hcy),high mobility group protein B1(HMGB1)and Toll-like receptor 4(TLR4)at admission with monocyte macrophage polarization in the patients with acute cerebral infarction(ACI).Methods A total of 107 patients with ACI admitted to this hospital from August 2020 to August 2022 were selected as the case group,and 50 healthy individuals undergoing physical examinations during the same period were selected as the control group.The serum Hcy,HMGB1 and TLR4 levels at admission were compared between the two groups,and the polarizations of monocyte macrophages[M1 type cells ratio,M2 type cells ratio,M1/M2 ratio,M1 type polarization markers(IL-1β,TNF-α),M2 type polarization markers(IL-10,TGF-β)]were compared between the two groups.The relationship between Hcy,HMGB1 and TLR4 with monocyte macrophage polarization in ACI patients was analyzed,and the relationship between Hcy,HMGB1 and TLR4 levels with prognosis of ACI patients was also analyzed.According to the prognosis of ACI patients,they were divided into the good prognosis group and poor prognosis group,and their serum Hcy,HMGB1 and TLR4 levels were compared between the two groups.The predictive efficiency of Hcy,HMGB1 and TLR4 on the prognosis of ACI was analyzed through the receiver operating characteristic(ROC)curves.Results Compared with the control group,the levels of serum Hcy,HMGB1 and TLR4 in the case group were significantly increased(P<0.05).Compared with the control group,the ratio of M1 type cells,ratio of M1/M2 and levels of IL-1βand TNF-αin the case group were significantly increased(P<0.05),while the levels of IL-10 and TGF-βwere significantly decreased(P<0.05).The Pearson correlation analysis results showed that the levels of serum Hcy,HMGB1 and TLR4 in the patients with ACI were positively correlated with the ratio of M1 type cells,M1/M2 ratio,IL-1βlevel and TNF-αlevel(P<0.05),and negatively correlated with the levels of IL-10 and TGF-β(P<0.05).Compared with the good prognosis group,the

关 键 词：急性脑梗死 同型半胱氨酸 高迁移率族蛋白B1 Toll样受体4 单核巨噬细胞极化 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R446.1[医药卫生—临床医学]