| 杨 涛,赵舒怡,康 悦,许 迅,史明超,金庆文.不同神经功能缺损程度急性脑梗死患者Th17/Treg比值、CXCL9、CXCL12、CXCL16的变化及对短期预后的影响[J].,2022,(16):3158-3162 |
| 不同神经功能缺损程度急性脑梗死患者Th17/Treg比值、CXCL9、CXCL12、CXCL16的变化及对短期预后的影响 |
| Changes of Th17/Treg Ratio, CXCL9, CXCL12 and CXCL16 in Patients with Acute Cerebral Infarction with Different Degrees of Neurological Deficit and Their Effects on Short-Term Prognosis |
| 投稿时间：2022-02-03 修订日期：2022-02-26 |
| DOI：10.13241/j.cnki.pmb.2022.16.032 |
| 中文关键词: 神经功能缺损程度 急性脑梗死 Th17/Treg比值 CXCL9 CXCL12 CXCL16 预后 |
| 英文关键词: Degrees of neurological deficit Acute cerebral infarction Th17/Treg ratio CXCL9 CXCL12 CXCL16 Prognosis |
| 基金项目:国家自然科学基金项目（81671117） |
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| 中文摘要: |
| 摘要 目的：探讨不同神经功能缺损程度急性脑梗死（ACI）患者辅助性T细胞17（Th17）/调节性T细胞（Treg）比值、趋化因子（CXCL）9、CXCL12、CXCL16的变化及对短期预后的影响。方法：选取2020年4月20日至2021年1月10日期间我院收治的ACI患者96例作为研究对象，根据入院时美国国立卫生研究院卒中量表（NIHSS）评分将患者分为重度组（25例）、中度组（32例）和轻度组（39例）。根据改良Rankin量表（mRS）评分分为预后不良组（31例）和预后良好组（65例）。对比轻度组、中度组和重度组的外周血Th17/Treg比值、血清CXCL9、CXCL12、CXCL16水平；对比预后良好组和预后不良组的外周血Th17/Treg比值、血清CXCL9、CXCL12、CXCL16水平；采用单因素和多因素Logistic回归分析ACI患者预后不良的影响因素。结果：重度组、中度组的外周血Th17/Treg比值、血清CXCL9、CXCL12、CXCL16水平高于轻度组，且重度组高于中度组（P<0.05）。预后良好组的外周血Th17/Treg比值、血清CXCL9、CXCL12、CXCL16水平低于预后不良组（P<0.05）。单因素分析可知，预后不良与性别、年龄、体质量指数（BMI）、吸烟史、饮酒史、冠心病史、疾病梗死部位、治疗方式、发病至入院时间、同型半胱氨酸（Hcy）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、白细胞计数（WBC）无关（P>0.05）。而与糖尿病史、高血压史、低密度脂蛋白胆固醇（LDL-C）、颈动脉内膜中层厚度（IMT）、NIHSS评分有关（P<0.05）。糖尿病史、高血压史、LDL-C偏高、颈动脉IMT偏厚、NIHSS评分偏高是ACI患者预后的危险因素，而外周血Th17/Treg比值及血清CXCL9、CXCL12、CXCL16水平下降是ACI患者预后的保护因素（P<0.05）。结论：外周血Th17/Treg比值、CXCL9、CXCL12、CXCL16随着ACI病情进展呈升高现象，是影响ACI患者预后的重要影响因素，除此之外，糖尿病史、高血压史、LDL-C偏高、颈动脉IMT偏厚、NIHSS评分偏高也是预后不良的危险因素。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the changes of helper T cell 17 (Th17) / regulatory T cell (Treg) ratio, chemokine (CXCL)9, CXCL12 and CXCL16 in patients with acute cerebral infarction with different degrees of neurological deficit and their effects on short-term prognosis. Methods: 96 patients with ACI who were treated in our hospital from April 20, 2020 to January 10, 2021 were selected as the research objects. According to the National Institutes of Health Stroke Scale (NIHSS) score at admission, the patients were divided into severe group (25 cases), moderate group (32 cases) and mild group (39 cases). According to the modified Rankin Scale (mRS), the patients were divided into poor prognosis group (31 cases) and good prognosis group (65 cases). The peripheral blood Th17/Treg ratio and the levels of serum CXCL9, CXCL12 and CXCL16 in mild group, moderate group and severe group were compared. The peripheral blood Th17/Treg ratio, and the levels of serum CXCL9, CXCL12 and CXCL16 were compared between the good prognosis group and the poor prognosis group. Univariate and multivariate Logistic regression were used to analyze the influencing factors of poor prognosis in patients with ACI. Results: The peripheral blood Th17/Treg ratio, the levels of serum CXCL9, CXCL12 and CXCL16 in severe group and moderate group were higher than those in mild group, and the severe group was higher than the moderate group(P<0.05). The peripheral blood Th17/Treg ratio, the levels of serum CXCL9, CXCL12 and CXCL16 in the good prognosis group were lower than those in the poor prognosis group(P<0.05). Univariate analysis showed that the poor prognosis was not related to gender, age, body mass index (BMI), smoking history, drinking history, coronary heart disease history, disease infarction location, treatment mode, time from onset to admission, homocysteine (Hcy), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and leukocyte count (WBC)(P>0.05). It was related to the diabetes history, hypertension history, low density lipoprotein cholesterol (LDL-C), carotid intima-media thickness (IMT) and NIHSS score (P<0.05). The diabetes history, hypertension history, high LDL-C, thick carotid IMT and high NIHSS score were the risk factors for the prognosis of patients with ACI, while the decrease of peripheral blood Th17/Treg ratio and the serum CXCL9, CXCL12 and CXCL16 levels decreased were the protective factors for the prognosis of patients with ACI(P<0.05). Conclusion: Peripheral blood Th17/Treg ratio, CXCL9, CXCL12 and CXCL16 increase with the progression of ACI, which are important factors affecting the prognosis of patients with ACI. In addition, diabetes history, hypertension history, high LDL-C, thick carotid IMT and high NIHSS score are also risk factors for poor prognosis. |
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