The Role Of CD4~+T Lymphocyte In Peripheral Blood Of Large Area Cerebral Infarction And Its Changes With Time In One Week

Objective:To explore the role of Th1/Th2/Th17/Treg cells in large area cerebral infarction and the regularity of changes within a week of onset.Methods:According to the selection criteria and exclusion criteria,63 cases of acute cerebral infarction who were admitted to hospital within 72 hours in Department of Neurology,the First Hospital of Jilin University during April 2018 to December 2018,were taken part in this research.Among them,35 patients with large area cerebral infarction and 28 patients with non-large area cerebral infarction.All of them signed the informed consent and passed the discussion of the ethics committee of the First Hospital of Jilin University.Grouping: The experimental group was patients with large area cerebral infarction,patients whose infarct area of one hemisphere is greater than or equal to one third of the total area of unilateral hemisphere,whose infarct area of one brain stem is greater than or equal to one third of the total area of unilateral brain stem and whose infarct area of one cerebellar hemisphere is larger than or equal to one third of the total area of unilateral hemisphere confirmed by head CT or MRI.The experimental group was subdivided into lobe infarction group and brainstem infarction group according to the location of infarction,and divided into infection group and non-infection group according to the presence or absence of infection.Control group: Non-large area cerebral infarction patients with ischemic stroke.Peripheral venous blood was collected from the experimental group and the control group within 3 days,5 days and 7 days respectively.Peripheral venous blood was placed in the heparin anticoagulant tube and sent for examination within 6 hours.The general data of patients were recorded and the percentage of T lymphocyte subsets (Th1,Th2,Th17,Treg cells)in CD4 + T cells was determined by flow cytometry and Flowjo 10 software at three time points.Results:1.Th17 in 3 days,5 days and 7 days of onset in large area cerebral infarction group and non-large area cerebral infarction group were significantly different(P=0.009,0.000,0.005).Th2 on the 5th day of onset in large area cerebral infarction group and Non-large area cerebral infarction group was significantly different(P=0.014).2.Over time,in large area cerebral infarction group,Th1 and Th17 showed an upward trend,Treg showed a downward trend,Th2 showed an upward first and then a downward trend,but no statistical difference,Th1/Th2 showed no statistical difference.Th17/Treg has statistical difference(3d:7d,P=0.032;5d:7d,P=0.099);Th1,Th17,Th1/Th2 in non-massive cerebral infarction group showed a downward trend(P = 0.510,0.119,0.172),Treg and Treg/Th17 showed an upward trend(P = 0.553,0.157),Th2 showed a downward trend first and then an upward trend(P = 0.165),but there was no statistical difference.3.The percentage of Th1,Th2,Th17 and Treg cells in peripheral blood of patients with brainstem and lobe stroke did not change significantly within a week,and the levels of Th1,Th2,Th17 and Treg cells in peripheral blood of patients with brainstem and lobe stroke did not differ significantly in different periods.4.There was no significant difference in Th1 between infection group and non-infection group,but there was significant difference in Th2 between infection group and non-infection group on the 5th and 7th day(5d,infected : non-infected,P=0.027;7d,infected : non-infected,P=0.016).Th17 was significantly different between infected and non-infected groups on the 5th and 7th day(5d,infected : non-infected,P=0.047;7d,infected : non-infected,P=0.005).Treg was significantly different between infected and non-infected groups in 3 days,5 days and 7 days(3d,infected : non-infected,P=0.030;5d,infected : non-infected,p=0.029;7d,infected : non-infected,P=0.009).Conclusion:1.The inflammation reaction of large area cerebral infarction is more serious than that of Non-large area cerebral infarction within one week.It is mainly proinflammatory.Th1 and Th17 are increased,and Th17 is increased obviously.2.Brain stem infarction and lobar infarction may have no effect on T lymphocyte subsets in large area cerebral infarction.