急性脑梗死患者外周血T淋巴细胞水平与神经功能的相关性  

Correlation between peripheral blood T lymphocyte level and nerve function in patients with acute cerebral infarction

作　　者：朱浩 段飞 王沛 张潇 Zhu Hao;Duan Fei;Wang Pei;Zhang Xiao(Department of Neurology,the First People′s Hospital of Xianyang,Xianyang 712000,China;Department of Neurosurgery,the First People′s Hospital of Xianyang,Xianyang 712000,China;Department of Neurology,the First Affiliated Hospital of Air Force Military Medical University(Xijing Hospital),Xi′an 710077,China)

机构地区：[1]咸阳市第一人民医院神经内科,咸阳712000 [2]咸阳市第一人民医院神经外科,咸阳712000 [3]空军军医大学第一附属医院(西京医院)神经内科,西安710077

出　　处：《中国医师杂志》2024年第12期1761-1765,共5页Journal of Chinese Physician

基　　金：国家自然科学基金(82271317)。

摘　　要：目的探讨急性脑梗死患者外周血T淋巴细胞水平与神经功能的相关性。方法选择2020年5月至2023年5月咸阳市第一人民医院收治的100例急性脑梗死患者作为观察组,根据神经功能缺损程度分为轻度缺损(33例)、中度缺损(39例)、重度缺损(28例),另纳入同期医院体检健康者60例作为对照组,检测受试者外周血T淋巴细胞亚群水平,包括CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)。以Spearman等级相关系数分析患者外周血T淋巴细胞亚群水平与神经功能缺损程度的相关性;绘制受试者工作特征(ROC)曲线分析外周血T淋巴细胞亚群评估急性脑梗死中重度神经功能缺损的价值;采用多因素logistic逐步回归分析急性脑梗死中重度神经功能缺损的影响因素。结果观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平低于对照组,CD8^(+)水平高于对照组(均P<0.05);在轻度、中度、重度神经功能缺损患者中,CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平逐渐降低,CD8^(+)水平逐渐升高(均P<0.05);经Spearman相关性分析,急性脑梗死患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平与神经功能缺损程度存在负相关,CD8^(+)水平与神经功能缺损程度存在正相关(均P<0.05);经ROC曲线分析,CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)评估急性脑梗死中重度神经功能缺损的AUC分别为0.808、0.874、0.833、0.782,灵敏度分别为0.791、0.821、0.806、0.716,特异度分别为0.758、0.818、0.788、0.727(均P<0.05);与轻度缺损患者相比,中重度缺损患者合并糖尿病、Toast分型中的心源性脑栓塞、梗死面积>3 cm 2的比例较高(均P<0.05);多因素logistic回归分析显示,合并糖尿病、Toast分型、梗死面积、CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平是急性脑梗死中重度神经功能缺损的影响因素(均P<0.05)。结论与正常人群相比,急性脑梗死患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平偏低,CD8^(+)水平偏高,并且T淋巴细胞水平与患者神ObjectiveTo investigate the correlation between peripheral blood T lymphocyte level and nerve function in patients with acute cerebral infarction.MethodsA total of 100 patients with acute cerebral infarction admitted to the First People′s Hospital of Xianyang from May 2020 to May 2023 were selected as the observation group.According to the degree of neurological impairment,they were divided into mild injury(33 cases),moderate injury(39 cases)and severe injury(28 cases).Another 60 healthy subjects in hospital during the same period were included as the control group.The levels of peripheral blood T lymphocyte subsets,including CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+),were detected.Spearman correlation coefficient was used to analyze the correlation between the level of peripheral blood T lymphocyte subsets and the degree of neurological impairment.Receiver operating characteristic(ROC)curve was drawn to analyze the value of T lymphocyte subsets in peripheral blood in the assessment of moderate and severe neurological impairment in acute cerebral infarction.Multivariate logistic stepwise regression was used to analyze the influencing factors of severe neurological impairment in acute cerebral infarction.ResultsThe levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in observation group were lower than those in control group,and CD8^(+)levels were higher than those in control group(all P<0.05).The levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)were gradually decreased and CD8^(+)levels were gradually increased in patients with mild,moderate and severe neurological impairment(all P<0.05).Spearman correlation analysis showed that the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)were negatively correlated with the degree of neurological impairment in patients with acute cerebral infarction,and CD8^(+)was positively correlated with the degree of neurological impairment(all P<0.05).According to ROC curve analysis,area under the curve(AUC)of CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)in evaluating severe neurological impairment in acute cereb

关 键 词：急性脑梗死 T淋巴细胞 神经功能 

分 类 号：R743.33[医药卫生—神经病学与精神病学]