急性脑梗死患者血清C反应蛋白/脂联素和T细胞亚群与临床预后及神经功能的关系

摘要

目的:探讨急性脑梗死患者血清中C反应蛋白(CRP)/脂联素(APN)、T细胞亚群与临床预后及神经功能的关系.方法:选取我院2013年9月~2016年9月间收治267例急性脑梗死患者为研究对象,分为预后不良组(观察1组)及预后良好组(对照1组)及NIHSS评分≤19分组(观察2组)及≥NIHSS评分20分组(对照2组).所有患者入院后监测患者血清中CRP、APN水平、辅助性T细胞水平(辅助性Th17细胞、调节性Treg细胞).结果:观察1组和2组患者血清CRP、CRP/APN水平分别高于对照1组和2组,而观察1组和2组APN水平低于对照1组和2组(P<0.05);观察1组和2组Th17细胞和Th17/Treg分别低于对照1组和2组(P<0.05).采用logisitic回归分析探讨影响急性脑梗死预后和NIHSS评分的因素,多因素分析提示CRP/APN和Treg细胞/Th17细胞是急性脑梗死患者死亡的独立危险因素.结论:血清中CRP/APN水平及T细胞亚群与急性脑梗死患者临床预后和NIHSS评分密切相关,是临床预后和NIHSS评分的独立危险因素.%Objective:To investigate the relationship between the levels of C reactive protein (CRP) and adi-ponectin (APN) and prognosis and NIH stroke scale(NIHSS) in patients with acute cerebral infarction.Methods:267 cases of acute cerebral infarction patients in our hospital from September 2015 to September 2016 were selected as subjects. The study subjects were divided into 2 groups with poor prognosis(the observation 1 group) and good prognosis (the control 1 group) and 2 groups with NIHSS≤19(the observation 2 group) and NIHSS≥20(the con-trol 2 group). All patients were monitored for CRP, APN level, and auxiliary T cell level (auxiliary Th17 cells,regulatory Treg cells) in serum. Result:The serum CRP and CRP/APN levels in the observation 1 group and the observation 2 group were much higher than that of the control 1 group and the control 2 group (P<0.05). The Th17 and Th17/Treg cells in the observation 1 group and the observation 2 group were significantly lower than that of the control 1 group and the control 2 group (P<0.05). The multivariate analysis showed that CRP/APN and Treg/Th17 were independent risk factors of both prognosis and NIHSS. Conclusion:The clinical outcomes of CRP/APN level and T cell subgroups in serum were closely related to the clinical prognosis of patients with acute cerebral infarction and NIHSS score,which were independent risk factors for clinical prognosis and NIHSS score.