丙氨酰-谷氨酰胺配合高压氧治疗对中青年脑卒中患者恢复期外周血T淋巴亚群及miR-124、miR-181c的影响
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1.山西省晋中市第二人民医院 2.神经内科 3.山西 晋中 4.03080013152910615 dffocs@163.com

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Effect of Alanyl-Glutamine Combined with Hyperbaric Oxygen Therapy on Peripheral Blood T Lymph Subgroups, miR-124 and miR-181c in Young and Middle-aged Stroke Patients
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    [摘要]目的:探究丙氨酰-谷氨酰胺配合高压氧治疗对中青年脑卒中患者恢复期外周血T淋巴亚群及微小RNA-124(miR-124)、miR-181c的影响。方法:选取2017年7月~2021年7月我院96例中青年脑卒中恢复期患者作为研究对象,依据随机数字表法分为3组,各32例。3组均予以脑卒中恢复期常规治疗,于此基础上,对照A组予以丙氨酰-谷氨酰胺治疗,对照B组予以高压氧治疗,观察组予以丙氨酰-谷氨酰胺配合高压氧治疗,均连续治疗4周。比较3组治疗前、治疗2周后、4周后神经功能(NIHSS评分)、日常生活能力(BI指数)、肢体运动功能(FMA评分)、炎症因子[肿瘤坏死因子-α(TNF-α)、单核细胞趋化蛋白-1(MCP-1)、白细胞介素-12(IL-12)]、外周血T淋巴亚群(CD4+、CD8+、CD4+/CD8+)、脑血流动力学[颈动脉最小血流速度(Vmin)、最小血流量(Qmin)]、miR-124、miR-181c表达。结果:观察组治疗2周后、4周后NIHSS评分低于对照A组、对照B组,BI指数高于对照A组、对照B组(P<0.05);观察组治疗2周后、4周后上、下肢肢体运动功能评分高于对照A组、对照B组(P<0.05);观察组治疗2周后、4周后血清TNF-α、MCP-1、IL-12水平低于对照A组、对照B组(P<0.05);观察组治疗2周后、4周后CD4+、CD4+/CD8+高于对照A组、对照B组,CD8+低于对照A组、对照B组(P<0.05),且对照A组CD4+、CD4+/CD8+高于对照B组,CD8+低于对照B组(P<0.05);观察组治疗2周后、4周后Vmin、Qmin高于对照A组、对照B组(P<0.05),且对照B组Vmin、Qmin高于对照A组(P<0.05);观察组治疗2周后、4周后miR-124、miR-181c表达低于对照A组、对照B组(P<0.05)。结论:丙氨酰-谷氨酰胺配合高压氧治疗能进一步改善恢复期中青年脑卒中患者细胞免疫功能,下调miR-124、miR-181c表达水平,显著改善患者神经功能及日常生活能力。

    Abstract:

    Abstract Objective: To explore the effects of alanyl-glutamine combined with hyperbaric oxygen therapy on peripheral blood T-lymph subgroups, microRNA-124 (miR-124) and miR-181c in young and middle-aged stroke patients during the recovery period.Methods: 96 middle-aged and young patients with stroke recovery in our hospital from July 2017 to July 2021 were selected as the research objects, and they were divided into 3 groups according to the random number table method, with 32 cases in each group. The three groups were given conventional treatment during the recovery period of stroke. On this basis, the control group A was given alanyl-glutamine treatment, the control group B was given hyperbaric oxygen therapy, and the observation group was given alanyl-glutamine combined with hyperbaric oxygen The treatment was continued for 4 weeks. Compare the three groups before treatment, after 2 weeks of treatment, and 4 weeks after treatment. Nerve function (NIHSS score), ability of daily living (BI index), limb motor function (FMA score), inflammatory factors [tumor necrosis factor-α (TNF-α) , Monocyte chemoattractant protein-1 (MCP-1), interleukin-12 (IL-12)], peripheral blood T lymphoid subsets (CD4+, CD8+, CD4+/CD8+), cerebral hemodynamics [neck Arterial minimum blood flow velocity (Vmin), minimum blood flow (Qmin)], miR-124, miR-181c expression.Results: After 2 weeks and 4 weeks of treatment in the observation group, the NIHSS score was lower than that of the control group A and control group B, and the BI index was higher than that of the control group A and control group B (P<0.05); The observation group was treated for 2 weeks and 4 weeks later The motor function scores of upper and lower limbs were higher than those of control group A and control group B (P<0.05); Serum TNF-α, MCP-1 and IL-12 levels of observation group were lower than control group A after 2 weeks and 4 weeks of treatment Group, control group B (P<0.05); After 2 weeks and 4 weeks of treatment in the observation group, CD4+, CD4+/CD8+ were higher than control group A and control group B, and CD8+ was lower than control group A and control group B (P<0.05 ), and the CD4+, CD4+/CD8+ of control group A were higher than control group B, and CD8+ was lower than control group B (P<0.05); Vmin and Qmin of observation group were higher than those of control group A and control B after 2 weeks and 4 weeks of treatment Group (P<0.05), and the Vmin and Qmin of the control group B were higher than those of the control group A (P<0.05); The expression of miR-124 and miR-181c in the observation group was lower than that of the control group A and control after 2 weeks and 4 weeks Group B (P<0.05).Conclusion: Alanyl-glutamine combined with hyperbaric oxygen therapy can further improve the cellular immune function of the young and middle-aged stroke patients during the recovery period, down-regulate the expression levels of miR-124 and miR-181c, and significantly improve the patients' neurological function and ability of daily living.

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  • 收稿日期:2021-12-08
  • 最后修改日期:2022-05-13
  • 录用日期:2022-08-16
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