Clinical Significance Of CD4~+ CD25~+ Regulatory T Cells (Treg) Frequency In Peripheral Blood Of Patients With Acute Cerebral Infarction

Objective:To investigate CD4+CD25+ regulatory T cells(Treg)frequency in peripheral blood of patients with acute cerebral infarction at different times and the relationship between CD4+CD25+regulatory T cells(Treg)frequency and anterior or posterior circulation,TOAST genotype,neurological deficit,neurological function recovery and whether the infection occurred in the course of disease.To elucidate the clinical significance of CD4+CD25+ regulatory T cells(Treg)in the acute phase of cerebral infarction.Methods:1.A total of 61 patients with acute cerebral infarction(infarct group)and 29 healthy subjects(control group)were enrolled in the Department of Neurology,Subei Hospital,Yangzhou,Jiangsu province,August 2016 to February 2017 to collect general clinical data,distinguish between anterior and posterior circulation infarction and TOAST classification;2.The neurological deficits were divided into mild group(0-4 points),moderate group(5-15 points),severe group(16-42 points)according to NIHSS score;3.The prognosis is divided into groups with good outcome(mRS 0-2)and poor outcome group(mRS 3-6)according to 30d Modified Rankin Scale(mRS);4.To observe the occurrence of infection in patients with cerebral infarction during hospitalization;5.The peripheral blood CD4+CD25+ regulatory T cells(Treg)frequency were measured by flow cytometry in peripheral blood of patients with infarct and control;6.To analyze the relationship between CD4+CD25+ regulatory T cells(Treg)in peripheral blood of patients with acute cerebral infarction at different time frequency and anterior or posterior circulation,TOAST classification,neurological deficit,neurological function recovery and infection.Results:①The frequency of Treg in the peripheral blood of patients with acute cerebral infarction on the first day and the fifth day were not statistically significant(P>0.05)compared with those of the anterior or posterior circulation and TOAST classification.②There was a significant difference between the frequency of Treg in the peripheral blood and the degree of neurological deficits at admission on the first day of acute cerebral infarction(P<0.001).The result shows:Peripheral blood Treg frequency on the first day of the mild neurological deficits group were higher than the severe neurological deficits group,which had a significant difference,compared with the moderate neurological deficits group,the difference did not reach statistical significance;Simultaneously the frequency in the moderate neurological deficits group was higher than the severe group,which had a significant difference.Peripheral blood Treg frequency on the first day of the control group were higher than the moderate neurological deficits group and the severe neurological deficits group,which had a significant difference,compared with the mild neurological deficits group,the difference did not reach statistical significance.There was no significant difference between the frequency of Treg in peripheral blood on the fifth day of acute cerebral infarction and the degree of neurological deficits at admission.Peripheral blood Treg frequency on the first day of the control group were lower than the frequency of Treg in peripheral blood on the fifth day of acute cerebral infarction,which had a significant difference.③There was a significant difference between the frequency of Treg in the peripheral blood on the first day of the patients with cerebral infarction and the recovery of 30-day neurological function(P<0.05).Peripheral blood Treg frequency of good outcome group on the first day were higher than the poor outcome group,which had a significant difference;There was no significant difference between the frequency of Treg in peripheral blood on the fifth day of acute cerebral infarction patients and the recovery of 30-day neurological function.④The frequency of Treg in peripheral blood on the first day of cerebral infarction patients with infection were obviously lower than the patients without infection,which had significant difference(P<0.001);The fifth day peripheral blood Treg frequency of cerebral infarction patients with infection had no significant difference compared with patients without infection(P>0.05).Conclusion:①The frequency of Treg cells in the peripheral blood of patients with cerebral infarction was related to the degree of neurological deficits on the day of admission.The more severe the neurological deficit,the lower the frequency of peripheral blood Treg cells on the first day;②The frequency of Treg cells in peripheral blood of patients with cerebral infarction was related to the degree of neurological recovery after 30 days.The lower the frequency of peripheral blood Treg cells on the first day,the worse the recovery of nerve function after 30 days;③The low frequency of peripheral blood Treg was associated with infection in the first day of acute cerebral infarction.