Level Changes And Its Clinical Significance Of Peripheral Blood CD4+CD25+Regulatory T Cell (Treg) In Patients With Acute Atherosclerotic Cerebral Infarction

China’s development of health statistical bulletin from Statistical InformationCenter in2011shows that the incidence and mortality of atherosclerotic cerebralinfarction is rising year by year, and poses aserious threate to human health inChina.There are immune inflammatory reaction in atherosclerosis andatherosclerotic cerebral infarction, Immune balance between Pathogenic T cells（Tp）and Immune regulatory T cells（Tr）play an important role in the progression ofatherosclerosis. More and more research proof that CD4+CD25+regulatory T cell（Treg）is a new type of immune regulatory T cells, it can resist atherosclerosis andreduce arteriosclerotic cerebral infarction immune damage effect. Clear its functionand mechanism of action in peripheral blood, and given early intervention andtreatment measures, To inhibit or delay atherosclerosis process, Protecting targetorgan has important significance.Clear its function and mechanism of action inperipheral blood, and given early intervention and treatment measures play animportant role in inhibiting or delaying atherosclerosis process, ang protecting targetorgan.There are a large number of reports at home and abroad, the number ofperipheral blood CD4+CD25+regulatory T cell（Treg） significantly decreased inpatients after acute myocardial infarction, but there is few reports on thedetermination of the level of peripheral blood CD4+CD25+regulatory T cell（Treg）in patients with acute cerebral infarction(ACI), and it has not seen the reportsLevel changes of peripheral blood CD4+CD25+regulatory T cell（Treg）in patientswith acute atherosclerotic cerebral infarction and its relationship with carotidatherosclerosis at home. In this study, determining the level of peripheral blood CD4+CD25+regulatory T cel（lTreg）with flow cytometry within7days of onset ofacute atherosclerotic cerebral infarction (ie, infarct group), and healthy hospital overthe same period (ie, control group), comparing the Level changes of peripheral bloodCD4+CD25+regulatory T cel（lTreg）, and analyze level changes of peripheral bloodCD4+CD25+regulatory T cell（Treg）at different time in acute atheroscleroticcerebral infarction, and its relationship with degree of neurological deficit, infarctlesion volume and carotid artery atherosclerosis in the correlation to explore theclinical significance of peripheral blood CD4+CD25+regulatory T cell（Treg） inischemic brain injury.Study selection and exclusion criteria in accordance with collection in February2012~December2012in Union Hospital of Jilin University in the Department ofNeurology at the hospital within7days of onset of acute atherosclerotic cerebralinfarction (ie, infarction group)48cases, and the same period healthy patients (ie,control group)30cases as research subjects. All cases are in line with the NationalConference on the Fourth Amendment cerebrovascular disease diagnostic criteria, andby history、CT and (or) MRI examination confirmed. Infarction group according toThe United States national institutes of health stroke scale (NIHSS)with neurologicaldeficit scores:0to15are divided into groups with mild neurological deficits;16to30are divided into groups with moderate neurologic impairment;31to45are severeneurological deficit group; Infarction patients according to Pullicino formula (length×width×CT or MRI scans positive layers/2) calculated infarct lesion volume, anddivided into small, medium, and big hearths three groups,<5cm3for the small focalgroup,5~10cm3in the kitchen for the group,>10cm3for the big hearths group;Infarction patients were confirmed carotid atherosclerosis (CAS) by carotidultrasound, according to the severity into three groups: group of carotid artery intimalthickening (A sub-group), carotid artery plaque group (B sub-group) and carotidstenosis group (C sub-group). Determined by flow cytometry all levels of peripheralblood CD4+CD25+regulatory T cell（Treg）were compared the level of peripheralblood CD4+CD25+regulatory T cell（Treg）in each group and analyze level changesof peripheral blood CD4+CD25+regulatory T cell（Treg）at different time in acuteatherosclerotic cerebral infarction, and its relationship with degree of neurological deficit, infarct lesion volume and carotid artery atherosclerosis in the correlation,and the results were statistically analyzed.The results showed that:①The percentage of peripheral blood CD4+CD25+regulatory T cell（Treg）in infarction patients is lower than the control group in thefirst and the second day,it is higher than the control group in the fifth and the seventhday, the difference was statistically significant (p<0.05), it is lower than the controlgroup in the third day, the difference was not statistically significant（p＞0.05）.②thepercentage of peripheral blood CD4+CD25+regulatory T cell（Treg）with differentdegree of neurological deficit in infarction patients is significantly lower than thecontrol group, the difference was statistically significant (p<0.05); Among them, theheavy percentage of peripheral blood CD4+CD25+regulatory T cell（Treg）is lowerthan the moderate group, while the moderate percentage of peripheralblood CD4+CD25+regulatory T cell（Treg）is lower than the mild group, thedifference was statistically significant (p<0.05). In infarction group, the study alsofound that the percentage of CD4+CD25+regulatory T cell（Treg） in peripheralblood of patients with neurologic impairment score was negatively correlated (r=-0.794, p<0.01).③the percentage of peripheral bloodCD4+CD25+regulatory Tcell（Treg）with different infarct lesion volume in infarction patients is significantlylower than the control group, the difference was statistically significant (p<0.05);Among them, the stove percentage of peripheral blood CD4+CD25+regulatory Tcell（Treg） group is lower than group in the kitchen, while the kitchen percentage ofperipheral blood CD4+CD25+regulatory T cel（lTreg）group is lower than the smallfocal group, the differences were statistically significant (p<0.05). In infarction group,the study also found that the percentage of CD4+CD25+regulatory T cell（Treg） inperipheral blood of patients with infarct lesion volume was negatively correlated (r=-0.559, p<0.01).④A、B and C sub-group patients the percentage of peripheralblood CD4+CD25+regulatory T cell（Treg） is lower than the control group. Where,the percentage of peripheral blood CD4+CD25+regulatory T cell（Treg） in Csub-group is lower than the B sub-group, while the percentage of peripheral bloodCD4+CD25+regulatory T cell（Treg） in B sub-group is lower than the A sub-group,the differences were statistically significant (p<0.05). The study also found that the percentage of peripheral blood CD4+CD25+regulatory T cell（Treg） and carotidartery-medial thickness (IMT) was significantly negatively correlated (r=-0.543,p<0.01).In summary, the following conclusions:①Level changes of peripheralblood CD4+CD25+regulatory T cell（Treg）in patients with acute atheroscleroticcerebral infarction can be severd as the non-invasive indexes in early evaluation ofbrain ischemia.②In patients with acute atherosclerotic cerebral infarction the levelof peripheral blood CD4+CD25+regulatory T cell（Treg） and neurological deficitsand infarct volume, suggesting that it may be used as a sensitive index which reflectthe severity of ischemic brain injury.③In patients with acute atherosclerotic cerebralinfarction the level of peripheral blood CD4+CD25+regulatory T cell（Treg） andcarotid atherosclerosis severity, suggesting that it could be used as an objectiveindicator which judge the severity of carotid artery atherosclerosis.④CD4+CD25+regulatory T cell （Treg） play resistance atherosclerosis effect by inhibititionendothelial cell inflammatory secretory function and introduced antigen presentingfunction, the level of peripheral blood CD4+CD25+regulatory T cell（Treg） canreflect changes in endothelial function, so that it can be used as cytological markerswhich evaluate early vascular endothelial function in patients with ischemic stroke.