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目的研究脑卒中患者外周血中树突状细胞(DCs)的变化规律。方法选择2014年6~9月在北京博爱医院神经康复科住院的脑梗死患者30例和脑出血患者26例,依据美国国立卫生院神经功能缺损评分(NIHSS)标准评价脑卒中的严重程度。同时选择健康体检者14名作为正常对照组。采用流式细胞技术检测三组外周血中DCs各亚型的比例。结果三组间外周血中DCs的数量无统计学差异,但其亚型的比例具有明显变化。与对照组相比,脑出血和脑梗死患者骨髓样树突状细胞(m DCs)占外周血树突状细胞的比例均显著减少(P<0.001)。脑出血患者外周血浆细胞样树突状细胞(p DCs)的比例下降(P<0.05),脑梗死患者p DCs比例降低更加显著(P<0.001)。根据NIHSS评分,脑出血和脑梗死患者分别分成NIHSS≤7组和NIHSS>7组。脑出血和脑梗死患者NIHSS>7组p DCs的比例均低于NIHSS≤7组(P<0.05),但NIHSS>7组m DCs比例与NIHSS≤7组无显著性差异。结论脑卒中患者外周血中DCs亚型的分布比例发生变化,提示免疫炎症反应在脑卒中发病过程中发挥作用。
Objective To study the changes of dendritic cells (DCs) in peripheral blood of patients with stroke. Methods Thirty patients with cerebral infarction and 26 patients with cerebral hemorrhage who were hospitalized in Department of Neurology and Rehabilitation of Beijing Pok Oi Hospital from June to September in 2014 were selected to assess the severity of stroke according to the National Institutes of Health Neurological Deficiency Index (NIHSS). At the same time, 14 healthy people were selected as normal control group. Flow cytometry was used to detect the proportion of DCs in three groups of peripheral blood. Results There was no significant difference in the number of DCs among the three groups, but the proportion of subtypes had significant changes. Compared with the control group, the percentage of bone marrow-like dendritic cells (m DCs) in peripheral blood mononuclear cells was significantly decreased in patients with cerebral hemorrhage and cerebral infarction (P <0.001). The proportion of peripheral plasmacytoplasmic dendritic cells (p DCs) in patients with cerebral hemorrhage decreased (P <0.05), and the proportion of p DCs in patients with cerebral infarction decreased more significantly (P <0.001). According to NIHSS score, patients with cerebral hemorrhage and cerebral infarction were divided into NIHSS≤7 group and NIHSS> 7 group. The proportion of p DCs in NIHSS> 7 group was lower than that in NIHSS≤7 group (P <0.05) in patients with cerebral hemorrhage and cerebral infarction, but there was no significant difference between NIHSS> 7 groups and NIHSS≤7 group. Conclusion The distribution of DCs subtypes in peripheral blood of patients with stroke is changed, suggesting that immune and inflammatory reactions play a role in the pathogenesis of stroke.