急性脑梗死患者外周血Th17、Treg及Th17/Treg的变化及临床意义研究

目的 观察急性脑梗死(ACI)患者外周血辅助性T细胞17(Th17)和调节性T细胞(Treg)表达及其比值(Th17/Treg)的变化，并探讨临床意义。 方法 72例ACI患者，48例同期健康体检者为正常对照组，采用流式细胞术检测各组外周血中Th17及Treg占CD4+ T细胞比例。ACI患者按照美国国立卫生研究院卒中量表(NIHSS)分为轻型组、中型组和重型组3种不同神经功能缺损程度，根据Pullicino公式分为小梗死灶组、中梗死灶组、大梗死灶组3种不同梗死灶类型。同时分析Th17、Treg比例及Th17/Treg比值分别与NIHSS评分、梗死灶体积的相关性。 结果 ACI组患者Th17比例(7.26%±1.92%)、Th17/Treg比值(2.38±1.80)均显著高于与对照组(2.86%±0.65%,P＜0.05；0.35±0.07,P＜0.05)，Treg比例(4.29%±1.82%)显著低于对照组(8.03%±1.10%，P＜0.05)。ACI患者Th17比例和Th17/Treg比值及Treg比例在不同神经功能缺损程度和不同梗死灶类型中差异均有统计学意义(均P<0.05)。Th17/Treg比值分别与NIHSS评分、梗死灶体积呈正相关(r=0.865，0.672，P＜0.05)。 结论 ACI患者外周血Th17、Treg比例和Th17/Treg比值与急性脑梗死的严重程度密切相关，同时监测Th17/Treg比值的变化对评估患者的疾病进展具有一定临床参考意义。 

The expression and significance of Th17,Treg and Th17/Treg in peripheral blood of patient with acute cerebral infarction

Objective To explore the expression and significance of Th17,Treg and ratio of Th17 and Treg(Th17/Treg) in peripheral blood in patient with acute cerebral infarction. Methods Acute cerebral infarction(ACI) group (72 cases) and healthy control(HC) group(48 cases) were investigated.The levels of Th17 and Treg in peripheral blood were detected by Flow cytometry.According to National Institute of Health stroke scale(NIHSS) scores,ACI group was divided into light group,medium group and severe group.According to the Pullicino formula,divided into small infarction volume group,medium infarction volume group and big volume infarcts.In addition,Th17,Treg and Th17/Treg correlations with NIHSS and infarction volume were analyzed,respectively. Results The level of Th17[(7.26±1.92)%] and Th17/Treg(2.38±1.80) increased significantly(P<0.05) and the level of Treg[(4.29±1.82)%] decreased significantly(P<0.05),compared with HC group[(7.26±1.92)%,2.38±1.80,(8.03±1.10)%)].The differences in level of Th17,Th17/Treg and Treg in different infarction volume groups and different NIHSS scores groups were significantly,respectively(P<0.05).The correlation between Th17/Treg and NIHSS,infarction volume were significantly positive(r=0.865,r=0.672,P<0.05). Conclusion Th17 and Treg and Th17/Treg are closely related to the severity of acute cerebral infarction.To a certain extent,detecting the change of Th17/Treg can assessment progression of the disease.