Correlation between Peripheral Blood T Lymphocyte Subsets and Serum PAF,Cortisol Levels with the Severity and Prognosis of Acute Cerebral Infarction Patients

ZHAO Dongmei; ZHANG Yanling; LIU Qian; WANG Libo; DU Yuxin; CAO Feihu

doi:10.3639/j.issn.2095-3097.2025.05.012

Abstract：Objective To investigate the correlation between peripheral blood T lymphocyte subsets(CD4+,CD8+and CD4+/CD8+)and serum platelet activating factor(PAF)and cortisol(Cor)levels in relation to the severity and prognosis of acute cerebral infarction(ACI)in patients.Methods A total of 118 ACI patients who visited our hospital from January 2020 to April 2023 were included as the study group.According to the severity of their condition,patients were grouped into a mild group(46 cases),a moderate group(53 patients),and a severe group(19 patients).According to the follow-up results within one year,they were divided into a good prognosis group(83 patients)and a poor prognosis group(35 patients),and 97 healthy volunteers were selected as the control group.Another 97 healthy volunteers were selected as the control group.Spearman’s method was applied to analyze the correlation between serum levels of peripheral blood T lymphocyte subsets,serum PAF,and Cor levels,and the National Institutes of Health Stroke Scale(NIHSS)score.The predictive value of peripheral blood T lymphocyte subsets combined with serum PAF and Cor for the prognosis of ACI patients was evaluated using receiver operating characteristic(ROC)curve analysis.Results The CD4+and CD4+/CD8+levels in the study group were lower than those in the control group(P<0.05),while the CD8+levels and levels of serum PAF and Cor were higher than those in the control group(P<0.05).The CD4+and CD4+/CD8+levels in peripheral blood of ACI patients gradually decreased with increasing severity of disease(P<0.05),while the CD8+levels and levels of serum PAF and Cor showed a gradually increasing trend(P<0.05).CD4+and CD4+/CD8+were negatively correlated with NIHSS score(P<0.05),while CD8+,PAF,and Cor levels were positively correlated with NIHSS score(P<0.05).The CD4+and CD4+/CD8+levels in the poor prognosis group were lower than those in the good prognosis group(P<0.05),and the CD8+levels and levels of serum PAF and Cor were higher than those in the good prognosis group(P<0.05).The area under the curve(AUC)of CD4+,CD8+,CD4+/CD8+,serum PAF,and Cor in predicting the prognosis of ACI patients was 0.856,0.769,0.860,0.868,and 0.862,respectively.The AUC of the combined prediction was 0.975,which was better than that of their individual predictions(P<0.05).Conclusion The peripheral blood T lymphocyte subsets(CD4+,CD8+and CD4+/CD8+)and se-rum PAF and Cor levels in ACI patients are related to the severity of disease,and combined detection has good predictive value for the prognosis of ACI patients.