摘要
目的探讨外周血CD4^(+)CD25^(+)Treg细胞、TLR4、人巨细胞病毒(hCMV)-IgM与动脉粥样硬化型急性脑梗死(As-ACI)患者颈动脉粥样硬化的关系。方法选取89例As-ACI患者(脑梗死组),另选取健康体检者43例(对照组)。根据颈内动脉超声结果将As-ACI患者分为内膜正常组、内膜增厚组、斑块组、狭窄组。比较各组外周血CD4^(+)CD25^(+)Treg细胞水平、单个核细胞TLR4表达水平、hCMV-IgM抗体阳性率和内膜中膜厚度(IMT)。分析As-ACI患者颈动脉狭窄的危险因素,分析CD4^(+)CD25^(+)Treg细胞、TLR4与IMT的相关性及其对颈动脉狭窄的预测价值。结果脑梗死组CD4^(+)CD25^(+)Treg细胞、HDLC水平低于对照组,TLR4表达、hCMV-IgM抗体阳性率、TC、TG、LDLC、hs-CRP水平、IMT高于对照组(P<0.05)。内膜正常组、内膜增厚组、斑块组、狭窄组CD4^(+)CD25^(+)Treg细胞水平依次降低,TLR4表达、hCMV-IgM抗体阳性率、IMT依次增高(P<0.05)。CD4^(+)CD25^(+)Treg细胞水平与IMT呈负相关,TLR4表达与IMT呈正相关(P<0.05)。高血压、CD4^(+)CD25^(+)Treg表达、TLR4表达、hCMV-IgM抗体阳性是As-ACI患者颈动脉狭窄的危险因素(P<0.05)。CD4^(+)CD25^(+)Treg细胞、TLR4表达水平联合检测的预测价值高于单独检测(P<0.05)。结论外周血CD4^(+)CD25^(+)Treg细胞、TLR4、hCMV-IgM抗体阳性率与As-ACI患者颈动脉粥样硬化进展有关,外周血CD4^(+)CD25^(+)Treg细胞、TLR4联合可以较好预测病变过程。
Aim To explore the relationship between peripheral blood CD4^(+)CD25^(+)Treg cells,TLR4,human cytomegalovirus(hCMV)-IgM and carotid atherosclerosis in patients with atherosclerotic acute cerebral infarction(As-ACI).Methods Select 89 As-ACI patients(cerebral infarction group)and 43 healthy individuals(control group)for physical examination.According to the ultrasound results of the internal carotid artery,As-ACI patients were divided into normal endometrial group,endometrial thickening group,plaque group,and stenosis group.Compare the levels of CD4^(+)CD25^(+)Treg cells in peripheral blood,TLR4 expression in mononuclear cells,hCMV-IgM antibody positivity rate,and intima-media thickness(IMT)among different groups.Analyze the risk factors for carotid artery stenosis in As-ACI patients,and examine the correlation between CD4^(+)CD25^(+)Treg cells,TLR4,and IMT,as well as their predictive value for carotid artery stenosis.Results The levels of CD4^(+)CD25^(+)Treg cells and HDLC in the cerebral infarction group were lower than those in the control group,TLR4 expression,hCMV-IgM antibody positivity rate,TC,TG,LDLC,hs-CRP levels,IMT were higher in the cerebral infarction group than in the control group(P<0.05).The levels of CD4^(+)CD25^(+)Treg cells in the normal endometrial group,endometrial thickening group,plaque group,and stenosis group decreased sequentially,while the expression of TLR4,the positivity rate of hCMV-IgM antibody and IMT increased sequentially(P<0.05).The level of CD4^(+)CD25^(+)Treg cells is negatively correlated with IMT,while the expression of TLR4 is positively correlated with IMT(P<0.05).Hypertension,CD4^(+)CD25^(+)Treg expression,TLR4 expression,and positive hCMV-IgM antibody are risk factors for carotid artery stenosis in As-ACI patients(P<0.05).The predictive value of combined detection of CD4^(+)CD25^(+)Treg cells and TLR4 expression levels was higher than that of individual detection(P<0.05).Conclusion The levels of CD4^(+)CD25^(+)Treg cells,TLR4,and hCMV-IgM antibody positivity rate in peripheral blood are related to the progression of carotid atherosclerosis in As-ACI patients.The combination of CD4^(+)CD25^(+)Treg cells and TLR4 in peripheral blood can better predict the pathological process.
作者
杨琪
李芳芳
YANG Qi;LI Fangfang(Department of Neurology,Songzi People s Hospital,Songzi 434200,Hubei,China;Department of Neurology,Tongji Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei,China)
出处
《中南医学科学杂志》
CAS
2024年第1期123-127,共5页
Medical Science Journal of Central South China
