广西医学

目的分析缺血性脑卒中患者的外周血细胞分裂周期蛋白42(CDC42)表达水平、炎症相关Th和细胞因子水平，并探讨上述指标与神经功能缺损、焦虑/抑郁及认知功能障碍程度的相关性。方法纳入200例缺血性脑卒中患者、200例健康体检者分别作为观察组、对照组。比较两组外周血的CDC42 mRNA表达水平及Th1、Th2、Th17、白细胞介素（IL）-6、IL-10、肿瘤坏死因子α（TNF-α）水平。分析观察组上述指标与美国国立卫生院卒中量表（NIHSS）评分、焦虑自评量表（SAS）评分、抑郁自评量表（SDS）评分、简易智力状况检查（MMSE）量表评分的相关性。结果观察组的IL-6、TNF-α、Th1、Th17水平高于对照组，而CDC42 mRNA表达水平及Th2、IL-10水平低于对照组（P＜0.05）。观察组Th1、Th17、IL-6、TNF-α水平与NIHSS评分、SAS评分、SDS评分呈正相关，与MMSE量表评分呈负相关（P＜0.05），而CDC42 mRNA表达水平及IL-10、Th2水平与NIHSS评分、SAS评分、SDS评分呈负相关，与MMSE量表评分呈正相关（P＜0.05）。结论缺血性脑卒中患者外周血促炎性Th（Th1、Th17）及细胞因子（IL-6、TNF-α）水平升高，而抗炎性Th（Th2）及细胞因子（IL-10）水平降低，免疫调节因子CDC42表达水平下调，上述指标可在一定程度上反映患者的神经功能缺损、焦虑/抑郁及认知功能障碍程度，有助于监测患者的病情程度及进展情况。

【Abstract】ObjectiveTo analyze the peripheral blood cell division cyclin 42 (CDC42) expression, inflammation-related Th and cytokines levels of patients with ischemic cerebral stroke, and to explore the correlation of aforementioned indices with degrees of neurological deficit, anxiety/depression and cognitive dysfunction. MethodsA total of 200 patients with ischemic cerebral stroke, and 200 healthy check-up individuals were enrolled in observation group or control group, respectively. The mRNA expression of CDC42, and Th1, Th2, Th17, interleukin (IL)-6, IL-10, tumor necrosis factor α (TNF-α) levels in peripheral blood were compared between the two groups. The correlation of the aforementioned indices with scores of the National Institutes of Health Stroke Scale (NIHSS), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Mini Mental State Examination (MMSE) scale in the observation group was analyzed. ResultsThe levels of IL-6, TNF-α, Th1, and Th17 in the observation group were higher than those in the control group, while the mRNA expression of CDC42, and levels of Th2 and IL-10 were lower than those in the control group (P＜0.05). The levels of Th1, Th17, IL-6, and TNF-α positively correlated with NIHSS score, SAS score, and SDS score, whereas negatively correlated with MMSE scale score in the observation group (P＜0.05); nevertheless, the mRNA expression of CDC42, and levels of IL-10 and Th2 negatively correlated with NIHSS score, SAS score, and SDS score, while positively correlated with MMSE scale score in the observation group (P＜0.05). ConclusionPeripheral blood pro-inflammatory Th (Th1 and Th17), and cytokines (IL-6 and TNF-α) levels are elevated in patients with ischemic cerebral stroke, whereas anti-inflammatory Th (Th2) and cytokine (IL-10) levels are declined, and immunomodulatory factor CDC42 expression is down-regulated. The aforesaid indices can reflect degrees of neurological deficit, anxiety/depression, and cognitive dysfunction to a certain extent, and they are helpful to monitor extent and progress of patients′ disease.