Research On Relativity Between Intracranial And Extracranial Atherosclerosis And T Cell Subsets In Patients With Cerebral Infarction

ObjectiveTo evaluate the relationship of T cell subsets and intracranial and extracranial atherosclerosis and stability of carotid artery plaques in patients with cerebral infarction.MethodsBased on Trial of Org 10172 in Acute Stroke Treatment(TOAST)criteria,180patients with cerebral infarction were classified into large artery atherosclerosis stroke group,cardioembolism group,small-artery occlusion group,other type stroke group and cryptogenic stroke group.The cases were also divided into intracranial and extracranial without arteriostenosis group,intracranial arteriostenosis group,extracranial arteriostenosis group and intracranial and extracranial with arteriostenosis group according to CTA of head and neck.All of the arteriostenosis groups were further divided into mild,moderate and severe groups according to the degree of stenosis.Dividing the patients with no Intracranial artery stenosis,into no plaque group,stable plaque group,unstable plaque group according to the comprehensive results of cervical vascularultrasoundandcomputerizedtomographyangiography.Meanwhile,60 healthy persons were selected as the control group.T cell subsets levels between groups were compared.Results(1)The proportion of smokers,hypertensive patients,diabetes,low density lipoprotein,blood uric acid,homocysteine and CD4~+T cells in cerebral infarction group were significantly higher than those in control group.The high density lipoprotein(HDL)and CD8+T cells were significantly lower than those of the control group,and all the results were statistically significant(P<0.05).(2)CD4~+T cells of the large artery atherosclerosis stroke and small-artery occlusion patients was significantly higher than the cardioembolism other type stroke,the cryptogenic stroke and the controls.CD8+T cells had the opposite results,and the difference was statistically significant.(P<0.05).There was no significant difference in CD4~+T and CD8~+T cells between CE group,SOE group and SUE group compared with the control group(P>0.05).(3)CD4~+T cells of the arteriostenosis groups obviously higher than the group without arteriostenosis(P<0.05).CD8~+T cells had the opposite results(P<0.05).There was no significant difference in CD4~+T cell and CD8~+T cell level between the different stenosis groups(P>0.05).(4)Degree of intracranial and extracranial artery stenosis had positive correlation with CD4~+T cells,had negative correlation with CD8~+T cells.CD4~+T cells oh the mild,moderate and severe groups were significantly higher than those in the non-stricture group,while the CD8~+T cells were the opposite,and the difference was statistically significant(P<0.05).(5)In the non-intracranial artery stenosis group and the control group,the plaques of neck artery were mainly flat plaques and hard plaques,accounting for 68.3%and 86.9%respectively.The proportion of flat plaques and hard plaques in the non-intracranial artery stenosis group was significantly lower than that in the control group(P<0.05).The soft plaque and ulcer plaque for the carotid artery plaques were significantly higher than the control group(P<0.05);CD4~+T cells of the stable plaque group obviously higher than unstable plaque group(P<0.05),CD8~+T cells had no obvious difference.Conclusion(1)T cell subsets was closely correlated with the intracranial and external atherosclerosis of cerebral infarction.That is closely related to the large atherosclerotic cerebral infarction and lacunar cerebral infarction,and has no obvious correlation with other types of cerebral infarction.(2)T cell subsets are closely related to the degree of intracranial and extracranial artery stenosis.There was a positive correlation between the serum CD4~+T cells and the degree of intracranial and extracranial artery stenosis.However,there was a negative correlation between CD8~+T cells and the degree of intracranial and extracranial artery stenosis.(3)T cell subsets played a part in the development of carotid plaque.CD4~+T cells promote the development of plaque stability.CD8~+T cells had no correlation with plaque stability.