目的 研究调节性T细胞（regulatory T cells，Tregs）与急性脑梗死患者颈部动脉粥样硬化（carotid atherosclerosis，CAS）程度的相关性，以及复方丹参滴丸和瑞舒伐他汀对CAS患者Tregs水平的影响。方法 用流式细胞术（FCM）检测治疗组（复方丹参滴丸联合瑞舒伐他汀）及对照组（瑞舒伐他汀）治疗前后外周血中Tregs所占CD4⁺T细胞数的百分比，用酶联免疫吸附法（ELISA）测定外周血浆白细胞介素-10（IL-10）和转化生长因子-β1（TGF-β1）的浓度。结果 随着CAS程度加重，Tregs、IL-10和TGF-β1水平降低，治疗2周后，Tregs、IL-10、TGF-β1水平较治疗前升高，重度CAS组患者，治疗组Tregs、IL-10升高程度明显高于对照组。结论 Tregs占外周血CD4⁺T细胞的比例降低的程度可间接反映CAS病变的程度。联用他汀类药物与复方丹参滴丸除调脂作用外，还通过抗炎、抗氧化作用，上调Tregs、IL-10的水平，协同抗CAS。

Objective To study the correlation of regulatory T cells (Tregs) and carotid atherosclerosis (CAS) in patients with acute cerebral infarction, and the effects of Compound Danshen Dropping Pills and simvastatin on Tregs level in CAS patients. Methods Flow cytometry (FCM) was used to detect the percentage of Tregs in the peripheral blood of treatment group and control group before and after treatment. Plasma levels of interleukin 10 (IL-10), and transforming growth factor β1 (TGF-β1) were measured by enzyme linked immunosorbent assay (ELISA) method to detect IL-10 and TGF-β1 of peripheral blood plasma. Results With CAS aggravation, percentage of Tregs, IL-10, and TGF-β1 levels reduced. After two weeks of treatment, the levels of Tregs, IL-10, and TGF-β1 were higher than those before treatment. In severe CAS patients, Tregs and IL-10 increased significantly in treatment group than those in control group. Conclusion The proportion of Tregs in peripheral blood CD4+T cells can indirectly reflect the degree of CAS lesions. The combination of simvastatin and Compound Danshen Dropping Pills has lipid-regulation, anti-inflammatory, and anti-oxidant effect, and also up-regulates the levels of Tregs and IL-10, which can achieve the role of anti-atherosclerosis.

天津市卫生局科技攻关项目（13KG120）