高密度脂蛋白对缺血性脑卒中急性期患者外周血中免疫细胞分布的影响

张海岳; 关经纬; 王族; 武霄; 宋海庆; 孟然

doi:10.7619/jcmp.20212439

高密度脂蛋白对缺血性脑卒中急性期患者外周血中免疫细胞分布的影响

首都医科大学宣武医院神经内科, 北京, 100053

基金项目:

国家重点研发计划项目 2017YFC1308400

国家自然科学基金青年科学基金项目 81801143

详细信息

通讯作者:
孟然, E-mail: victor65@126.com

中图分类号: R743.3;R446.11
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出版历程
- 收稿日期: 2021-06-12
- 网络出版日期: 2021-08-24
- 发布日期: 2021-09-14

Influence of high-density lipoprotein on immune cells distribution in peripheral blood of patients with ischemic stroke at acute stage

Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, 100053

摘要

摘要:
目的分析高密度脂蛋白(HDL)对缺血性脑卒中急性期患者外周血中免疫细胞分布的影响。
方法纳入42例就诊于首都医科大学宣武医院的急性缺血性脑卒中患者为研究对象，所有患者发病至就诊时间均≤7 d。入院后治疗前均采集血标本，检测外周血中HDL的表达水平，应用流式细胞仪检测外周血中免疫细胞的百分比。根据HDL表达水平的不同将患者分为HDL < 1.0 mmol/L组(n=22)和HDL≥1.0 mmol/L组(n=20)。
结果 HDL < 1.0 mmol/L组外周血中CD3⁺T淋巴细胞、CD3⁺CD4⁺T淋巴细胞百分比高于HDL≥1.0 mmol/L组，但CD3⁺CD8⁺T淋巴细胞百分比低于HDL≥1.0 mmol/L组，差异均有统计学意义(P < 0.05)。2组患者外周血中单核细胞百分比差异无统计学意义(P > 0.05)。
结论在缺血性脑卒中急性期患者中，较高水平的HDL常伴有低水平的CD3⁺、CD3⁺CD4⁺T淋巴细胞的募集，这种结果可能有利于减少缺血性卒中后的脑组织损伤。
- 缺血性脑卒中 /
- 高密度脂蛋白 /
- T淋巴细胞 /
- 单核细胞 /
- 外周血 /
- 脑组织损伤
Abstract:
Objective To analyze the influence of high-density lipoprotein (HDL) on immune cells distribution in peripheral blood of patients with ischemic stroke at acute stage.
Methods Totally 42 patients with acute ischemic stroke in Xuanwu Hospital of Capital Medical University were selected as research objects, and the duration from onset to treatment was 7 days and below in all the patients. Blood samples were collected before treatment after admission, the expression level of HDL in peripheral blood was detected, and the percentage of immune cells in peripheral blood was detected by flow cytometer. The patients were divided into HDL < 1.0 mmol/L group (n=22) and HDL≥1.0 mmol/L group (n=20).
Results The percentages of CD3⁺ T lymphocytes and CD3⁺CD4⁺ T lymphocytes in peripheral blood in the HDL < 1.0 mmol/L group were significantly higher than those in the HDL≥1.0 mmol/L group, but the percentage of CD3⁺CD8⁺ T lymphocytes was significantly lower than that in the HDL≥1.0 mmol/L group (P < 0.05). There was no significant difference in the percentage of monocytes in peripheral blood between the two groups (P > 0.05).
Conclusion In patients with ischemic stroke at acute stage, the patients with higher level of HDL are often accompanied by the recruitment of low levels of CD3⁺ and CD3⁺CD4⁺ T lymphocytes, which may help to reduce brain tissue damage after ischemic stroke.
- ischemic stroke /
- high-density lipoprotein /
- T lymphocytes /
- monocyte /
- peripheral blood /
- brain tissue damage

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图 1 T淋巴细胞在缺血性脑卒中急性期患者外周血中的比率

A、B、C、D、E: 外周血T淋巴细胞流式细胞仪检测门控策略图; F: 2组CD3⁺T淋巴细胞百分比的比较，与HDL < 1.0 mmol/L组比较, P=0.032; G: 2组CD3⁺CD4⁺T淋巴细胞百分比的比较，与HDL < 1.0 mmol/L组比较, P < 0.000 1; H: 2组CD3⁺CD8⁺T淋巴细胞百分比的比较，与HDL < 1.0 mmol/L组比较, P=0.047。

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图 2 单核细胞在缺血性脑卒中急性期患者外周血中的比率

A、B、C: 外周血单核细胞流式细胞仪检测门控策略图; D: 2组总单核细胞百分比的比较; E: 2组CD14⁺CD16⁺单核细胞百分比的比较; F: 2组CD14⁺CD16^-单核细胞百分比的比较。

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图 3 倾向性评分匹配后T淋巴细胞和单核细胞在缺血性脑卒中急性期患者外周血中的比率

A: 2组匹配后CD3⁺T细胞占总淋巴细胞的比率; B: 2组匹配后CD3⁺CD4⁺T细胞占总淋巴细胞的比率; C: 2组匹配后CD3⁺CD8⁺T细胞占总淋巴细胞的比率; D: 2组匹配后总单核细胞百分比; E: 2组匹配后CD14⁺CD16⁺单核细胞百分比; F: 2组匹配后CD14⁺CD16^-单核细胞百分比。

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表 1 匹配前后患者临床资料比较(x±s)

临床资料	未匹配			倾向评分匹配后
临床资料	HDL < 1.0mmol/L	HDL≥1.0mmol/L	P		HDL < 1.0mmol/L	HDL≥1.0mmol/L	P
例数	22	20	—		13	13	—
女性	3	9	0.025		3	3	1.000
年龄/岁	57.45±12.79	58.10±10.54	0.860		55.62±13.05	55.54±11.82	0.988
发病时间/d	3.64±2.49	4.15±1.73	0.453		3.54±2.33	4.08±1.44	0.486
陈旧性脑梗死	3	0	0.087		0	0	—
高脂血症	12	10	0.768		6	7	0.695
高血压	16	15	0.867		9	11	0.352
糖尿病	11	5	0.096		4	4	1.000
低密度脂蛋白/(mmol/L)	2.42±0.90	2.37±0.63	0.844		2.44±1.07	2.38±0.68	0.873
同型半胱氨酸/(μmol/L)	13.44±2.37	14.08±3.90	0.520		13.40±1.73	13.90±4.57	0.716

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