急性动脉粥样硬化性脑梗死患者外周血CD137的表达特点及其临床意义

目的探讨急性动脉粥样硬化性脑梗死(atherosclerotic cerebral infarction,ACI)患者外周血肿瘤坏死因子受体超家族(tumor necrosis factor receptor super family,TNFRSF)成员CD137的表达特点及其临床意义。方法入选发病72h以内住院患者共46例,其中ACI组27例,无症状性颈动脉狭窄(asymptomatic carotid stenosis,ACS)组19例,另选择同期健康体检者20名为正常对照组(normal control,NC)。采用流式细胞术和流式细胞磁珠微阵列法(CBA)检测各组观察对象外周血CD4~+T细胞及其CD4~+CD28-T细胞亚群表面CD137的表达和血浆可溶性CD137水平。结果 ACI组外周血CD4~+CD28-T细胞比例(14.13±4.42)%]、CD4~+CD28-T细胞CD137的表达(2.60±2.14)%]、血浆sCD137(3.43±2.48)pg/mL]水平显著高于ACS组(9.03±4.60)%、(0.70±0.66)%、(2.07±0.814)pg/mL]和NC组(8.08±3.30)%、(0.45±0.31)%、(1.26±0.70)pg/mL](P0.01),且ACI组CD4~+T细胞的CD137表达及血浆sCD137水平与NIHSS评分(P0.05)和梗死体积(P0.01)呈正相关。结论 ACI患者发病早期CD4~+CD28-T细胞、CD4~+T细胞及其CD4~+CD28-T细胞表面CD137、血浆sCD137水平升高,且CD4~+T细胞的CD137表达及血浆sCD137水平与NIHSS评分呈正相关,提示其可能作为评估脑梗死临床严重程度的外周生物学标志。

The features of CD137 expression in peripheral blood of patients with acute atherosclerotic cerebral infarction and its clinical significance

Objective To investigate the features of tumor necrosis factor receptor superfamily (TNFRSF)member CD137 expression in peripheral blood of patients with acute atherosclerotic cerebral infarction (ACI)and explore its clinical significance. Methods A total of 46 inpatients within 72 h after disease onset were collected and then divided into two groups:the ACI group (27 cases),the asymptomatic carotid stenosis group (ACS,19 cases). The normal control (NC)group consisted of 20 healthy volunteers. Flow cytometry and cytometry beads assay (CBA)were respectively used to detect the CD137 expression on T cells and the plasma soluble CD137 levels in peripheral blood of the participants. Results Within 72 h after onset,the ACI group had a significant increase of CD4 + CD28 - T cell counts(14.13 ± 4.42 )%],a higher CD137 expression on CD4 +CD28 - T cells(2.60±2.14)]% and an increased level of plasma sCD137(3.43±2.48)pg/mL]compared with the ACS group (9.03 ± 4.60)%,(0.70 ± 0.66)%,(2.07 ± 0.814)pg/mL]and the normal controls(8.08 ± 3.30)%,(0.45 ± 0.31 )%,(1.26 ± 0.70 )pg/mL]. The CD137 expression on CD4 + T cells and the level of plasma sCD137 were correlated with NIHSS scores and volume of cerebral infarction in the ACI group(P <0.05, P <0.01). Conclusions CD4 + CD28 - T cell counts,the expression of CD137 on CD4 + T cells and CD4 + CD28 -T cells and the plasma sCD137 levels were significantly elevated in the early phase of ACI. The CD137 expression on CD4 + T cells and the level of plasma sCD137 were correlated with NIHSS scores in early phase of ACI.It indicates that they could be used as valuable peripheral biomarkers of stroke for evaluation of clinical disease severity to some extents.