急性脑梗死患者外周血单个核细胞toll样受体4的表达与临床的相关性

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1、急性脑梗死患者外周血单个核细胞Toll样受体4的表达与临床的相关性【摘要】目的:探讨急性脑梗死患者外周血单核细胞Toll样受体4(TLR4)的表达及其与患者的临床亚型及病情严重程度的相关性。方法:采用流式细胞仪分析技术和实时定量RTPCR技术分别测定66例急性脑梗死患者外周血单核细胞Toll样受体4的表达水平,于入院3d内病情稳定后对患者进行临床神经功能缺损程度评分,并按照OxfordCommunityStrokeProject完成脑梗死患者的临床分型。结果:与健康对照组相比,急性脑梗死患者外周血单个核细胞(PBMC)中TLR4蛋白表达的阳性率(66.87±16.27)%及表达量(即荧光强

2、度,11.62±4.39)均显著升高,差异有统计学意义(P<0.01)。66例脑梗死按照OxfordCommunityStrokeProject临床分型,分为TACI9例、PACI39例、POCI7例和LACI11例,PBMC中TLR4蛋白和mRNA的表达量在各组间的差异均无统计学意义;按神经功能缺损程度评分标准将66例患者分为轻型27例、中型30例和重型9例,各组PBMC中TLR4蛋白和mRNA的表达量差异有统计学意义(P<0.05)。PBMC中TLR4蛋白和mRNA的表达量与病情的严重程度均呈正相关(P<0.05)。结论:外周血单核细胞Toll样受体4的表达增高与急脑梗

3、死的发生和严重程度有密切关系,是脑梗死发病的一个危险因素。【关键词】Toll样受体4;急性脑梗死;脑梗死临床分型;神经功能缺损程度11　　[Abstract]AIM:ToinvestigatetheexpressionofTolllikereceptor4(TLR4)inperipheralbloodmononuclearcells(PBMC)ofpatientswithacutecerebralinfarctionanditscorrelationwithclinicalsubtypesandtheseverityofthedisease.METHODS:ThelevelsofmRNAa

4、ndproteinofTLR4inPBMCof66patientswithacutecerebralinfractionwereexaminedbyrealtimequantitativereversetranscriptionpolymerasechainreaction(RTPCR)andflowcytometry(FCM),respectively.ClinicalneurologicaldeficitscoreandOCSP(OxfordCommunityStrokeProject)clinicalsubtypewereperformedinthepatientswithin3d

5、aysafteradmission.RESULTS:TheexpressionofTLR4inPBMCofpatientswithacutecerebralinfraction(positiverate:66.87±16.27%,fluorescenceintensity:11.62±4.39)wassignificantlyhigherthannormalcontrols(P<0.01,respectively).66patientsweredividedinto4groupsbasedonOCSP.Therewere9patientswithTACI,39patientswithP

6、ACI,7patientswithPOCI,and11patientswithLACI.ThedifferencesintheexpressionlevelsofTLR4proteinandmRNAinthesegroupshavenostatisticsignificance.Meanwhile,therewere27mildcases,30mediancases,and9severecasesaccordingtotheneurologicaldeficitscore.Thedifferencesintheexpression11levelsofTLR4proteinandmRNAint

7、hesegroupshavestatisticsignificance(P<0.05).TheexpressionofTLR4proteinandmRNAwerecorrelatedpositivelywiththeseverityofthedisease(r=0.85,0.87;P=0.01,0.01).CONCLUSION:TheincreasedexpressionofTLR4maybeassoc