杨琪,李芳芳.外周血CD4+CD25+Treg细胞、TLR4、hCMV-IgM与动脉粥样硬化型急性脑梗死患者颈动脉粥样硬化的关系.[J].中南医学科学杂志.,2024,(1):123-127.
外周血CD4+CD25+Treg细胞、TLR4、hCMV-IgM与动脉粥样硬化型急性脑梗死患者颈动脉粥样硬化的关系
Relationship between peripheral blood CD4+CD25+Treg cells, TLR4, hCMV-IgM and carotid atherosclerosis in patients with atherosclerotic acute cerebral infarction
投稿时间:2023-03-15  修订日期:2023-12-10
DOI:10.15972/j.cnki.43-1509/r.2024.01.030
中文关键词:  As-ACI  颈动脉粥样硬化  CD4+CD25+Treg细胞  TLR4  hCMV-IgM [
英文关键词:As-ACI  carotid atherosclerosis  CD4+CD25+Treg cell  TLR4  hCMV-IgM
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作者单位E-mail
杨琪 松滋市人民医院神经内科,湖北松滋434200 e-mail为978628@qq.com,e-mail为249974843@qq.com 
李芳芳 华中科技大学同济医学院附属同济医院神经内科,湖北武汉430030 e-mail为978628@qq.com,e-mail为249974843@qq.com 
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中文摘要:
      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。
英文摘要:
      AimTo 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). MethodsSelect 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. ResultsThe 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). ConclusionThe 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.
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