首页|银杏二萜内酯葡胺治疗急性脑梗死患者外周血辅助型Th17细胞亚群水平改变与临床预后的关系

银杏二萜内酯葡胺治疗急性脑梗死患者外周血辅助型Th17细胞亚群水平改变与临床预后的关系

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目的 观察银杏二萜内酯葡胺(GDLM)治疗急性脑梗死患者外周血T细胞亚群的改变,并通过小鼠体内实验观察其对T细胞亚群的影响.方法 选取2018-2019年兰州大学第一医院神经内科收治的急性脑梗死患者80例,根据接受治疗方案的不同分为观察组和对照组.两组患者均接受标准治疗,观察组加用GDLM治疗.比较两组患者临床疗效和卒中量表评分(NHISS)、血清C反应蛋白(CRP)水平、外周血Th17细胞水平变化.将C57B/L6雄性小鼠分为PBS组和GDLM两组,分别给予腹腔注射PBS或GDLM,第5、10天分析小鼠脾、引流淋巴结细胞中Th17细胞的改变.结果 治疗前,两组患者NIHSS评分及血清CD4+T细胞基线水平之间的差异无统计学意义(P>0.05);治疗后,两组患者CD4+T细胞均较治疗前无明显变化,但血清CRP水平、CD4+IL-17A+T细胞(Th17细胞)均较治疗前降低(P<0.05);治疗后,观察组NIHSS评分低于对照组(P<0.05).注射后第5天,GDLM组小鼠脾CD4+CD44lowCD62Lhigh T细胞显著增加,差异有统计学意义(P<0.05),到第10天,GDLM组CD4+CD44lowCD62Lhigh T细胞仍略高于对照组.注射后5天,GDLM组小鼠脾Th17细胞表现出降低趋势,第10天时则明显低于对照组(P<0.05).结论 GDLM治疗急性脑梗死效果显著,其机制可能是通过调节患者外周血T细胞亚群水平,抑制T细胞活化,抑制Th17细胞分化进而改善神经功能障碍.
Changes in Th17 cell subsets in peripheral blood of patients with acute cerebral infarction treated with ginkgo diterpene lactone meglumine and its relationship with clinical prognosis
Objective To observe the T cell subsets in peripheral blood of patients with subacute cerebral infarction treated by Ginkgo diterpene lactone meglumine(GDLM).The effect of GDLM on T cell subsets was also observed in mice.Methods 80 patients with subacute cerebral infarction were included in Depart-ment of Neurology,The First Hospital of Lanzhou University,and were divided into two groups:the control group and the observction group.The control group received conventional treatment,and the observation group was treated with conventional treatment and GDLM.Clinical efficacy,neurological function,national institute of hea-lth stroke scores(NIHSS),level of CRP in serum,and frequency of Th17 cell subsets were compared between the two groups.In addition,C57B/L6 male mice were divided into a PBS and GDLM group.Mice were given intraperitoneal injection of PBS or GDLM and T cell subsets in spleen and draining lymph node were analyzed by FACS.Result Before treatment,there were no significant difference in NIHSS and serum CD4+T cell levels between the two groups(P>0.05).After treatment,CD4+T cell in both groups underwent no significant changes.But the level of serum CRP,frequency of CD4+IL-17A+T cells(Th17 cell)were decreased(P<0.05).Besides,NIHSS in the observation group were lower than those in the control group(P<0.05).To examine whether GDLM treatment in naïve mice alters Th17 and other T cell subsets in vivo,we intraperitoneally injected GDLM into naïve B6 male mice for 10 consecutive days.On day 5,CD4+CD44low CD62Lhigh T cells in GDLM group were significantly increased compared to that control group(P<0.05).And on day 10,CD4+CD44low CD62Lhigh T cells in GDLM group were still slightly higher.On day 5,splenic Th17 cells in GDLM group showed a decreasing trend,and were significantly lower than control group on day 10(P<0.05).Conclusion The GDLM had positive effect on subacute cerebral infarction,for which the regulation of the peripheral blood T cell subsets,especially the inhibitions of T cell activation and Th17 cell differentiation,should possibly be considered.

acute cerebral infarctionginkgo diterpene lactone glucamineTh17 cellnational institute of health stroke scoresC-reactive protein

田家乐、史梅、谷有全、姚利和、魏浩广、杨军清、雒扬

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兰州大学 第一临床医学院,甘肃 兰州 730000

兰州大学第一医院神经内科,甘肃 兰州 730000

兰州大学第一医院康复科,甘肃 兰州 730000

夏河县人民医院 内科,甘肃 甘南 747100

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急性脑梗死 银杏二萜内酯葡胺 Th17细胞 美国国立卫生研究院卒中量表评分 C反应蛋白

国家自然科学基金地区科学基金甘肃省自然科学基金重点项目甘肃省自然科学基金重点项目中央高校基本科研业务费资助项目甘肃省联合科研基金一般项目兰州市城关区科技人才创新创业项目甘肃省高等学校创新能力提升资助项目兰州市科技局科技项目专项中国博士后科学基金面上项目

8196029320JR5RA320JR10RA671lzujbky-2020-kb2223JRRA14952023RCCX00212019B-0032020-XG-472023M731460

2024

兰州大学学报(医学版)
兰州大学

兰州大学学报(医学版)

CSTPCD
影响因子:0.641
ISSN:1000-2812
年,卷(期):2024.50(4)
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