缺血性脑卒中后抑郁与T淋巴细胞分化群的相关性

目的探讨缺血性脑卒中后外周血T淋巴细胞亚群变化与缺血性脑卒中抑郁发病的相关性。方法选择2014-12-2015-06作者医院确诊的缺血性脑卒中患者60例,均完成相应影像学检查,并给予常规内科治疗。根据汉密尔顿抑郁量表评分(HAMD-17项)分为并发抑郁组30例(HAMD评分≥7分)和未并发抑郁组30例(HAMD评分7分),比较两组患者间临床资料(包括性别、年龄、吸烟、饮酒、脑卒中部位、合并慢性疾病)和相关神经系统评分〔包括美国卫生研究院神经功能缺损评分(NIHSS)、日常生活活动能力(Barthel指数)、简易精神状态量表评分(MMSE)〕的差异。另选取健康对照20名,应用流式细胞仪技术检测3组样本外周血T淋巴细胞分化群(CD4~+、CD8~+、CD4~+/CD8~+)变化。结果 (1)并发抑郁组与未并发抑郁组间临床资料和相关神经系统评分比较差异无统计学意义(P0.05)。(2)并发抑郁组血清CD4~+水平为(40.90±7.01)%,低于健康对照组的(49.90±7.62)%和未并发抑郁组的(45.73±8.23)%(均P0.05);并发抑郁组血清CD8~+水平为(27.27±8.29)%,高于健康对照组的(21.50±5.04)%(P0.05);健康对照组、未并发抑郁组、并发抑郁组血清CD4~+/CD8~+水平分别为2.45±0.69、2.01±0.75和1.60±0.42,组间比较差异有统计学意义(F=11.01,P0.05)。结论缺血性脑卒中后存在一定程度的免疫失衡,并发抑郁症患者失衡更明显,这种免疫失衡主要表现在辅助T淋巴细胞CD4~+降低。

Correlation between T lymphocyte subsets and post ischemic stroke depression

Objective To investigate the relationship between the change of T lymphocyte subsets in peripheral blood and post ischemic stroke depression . Methods A total of sixty subjects with definitely diagnosed ischemic stroke were selected from December 2014 to June 2015 . The corresponding imaging examination and routine treatment of internal medicine were performed among all patients . According to Hamilton depression scale (HAMD) ,all the patients were divided into two groups .The depression group included 30 patients whose HAMD‐17 score were greater than or equal to 7 and the stroke control group included 30 patients without depression whose HAMD‐17 score were less than 7 . The clinical data (gender , age , smoking , alcohol , chronic diseases , location of cerebral stroke ) and neurological scores including National Institute of Health Stroke Scale (NIHSS) ,Barthel index of activities of daily living (ADL) and Mini‐Mental State Examination (MMSE) were compared and analyzed .Twenty healthy persons were selected as the healthy control group .Flow cytometry was used to detect the subsets (CD4+ ,CD8+ ,CD4+ /CD8+ ) of T lymphocyte in the peripheral blood of the three groups . Results (1) There were no significant differences in the clinical data and neurological scores between the depression group and the stroke control group (P> 0.05) .(2) The level of CD4+ in the depression group (40.90 ± 7.01)% was significantly lower than that of the healthy controls (49.90 ± 7.62)% and the stroke control group (45.73 ± 8.23)% (P<0.05 ,respectively) .The level of CD8+in the depression group (27.27 ± 8.29)% was higher than that of the healthy controls (21.50 ± 5.04)% (P<0.05) . The levels of CD4+ /CD8+ in the three group were 2.45 ± 0.69 , 2.01 ± 0.75 , 1.60 ± 0.42 , the differences were all statistically significant (F= 11.01 , P< 0.05) .Conclusions There is a certain degree of immune imbalance in the patients after ischemic stroke . It is more obvious in the patients complicated with depression , the immune imbalance mainly reflected in the reduction of CD4+ in the helper T lymphocyte .