动脉硬化性脑血管病外周血和脑脊液免疫球蛋白系列指标的观察分析

检测了３４例动脉硬化性脑血管病患者（脑出血１６例、脑缺血１８例）急性发病后１．５～６ｄ内外周血血清（Ｓ）ＩｇＧ、ＩｇＡ、ＩｇＭ、Ｃ３、Ｃ４、ＣＨ５０与脑脊液（ＣＳＦ）白蛋白（Ａｌｂ）以及ＣＳＦＩｇＧ／ＳＩｇＧ比值，并与２０名患动脉硬化的“正常人”（无其他疾病）进行了比较。结果表明：（１）外周血ＩｇＧ、Ｃ３、Ｃ４、ＣＨ５０两组患者较正常人明显增高，两组患者间无显著性差异；三组间ＩｇＡ、ＩｇＭ无显著性差异。（２）ＣＳＦ中ＩｇＧ两组患者均增高，且出血组更明显；ＣＳＦＩｇＧ／ＳＩｇＧ比值出血组较缺血组明显增高；两组Ａｌｂ均增高，出血组更明显。提示该病发病后体液免疫增强，这可能是伴发肺部感染的免疫病理机制之一。出现血脑屏障功能损害且脑出血较缺血更为严重，并可能有ＩｇＧ的内源性合成，提示急性脑组织损伤后中枢神经系统的免疫应激反应以及中枢神经系统结构的完整性与免疫应答密切相关。上述外周血与ＣＳＦ各项指标测定结果的不同，说明神经免疫学的特殊性。     

载脂蛋白E与脑动脉硬化症

本文观察７８例脑动脉硬化症患者与对照组４４例，对其血清载脂蛋白Ｅ（ＡＰＯＥ）和高密度脂蛋白（ＨＤＬ－Ｃ）、低密度脂蛋白（ＬＤＬ－Ｃ）、胆固醇（ＴＣ）、甘油三脂（ＴＧ）、载脂蛋白ＡＩ（ＡＰＯＡＩ）、载脂蛋白Ｂ（１００）（ＡＰＯＢ（１００））进行含量测定，并将ＡＰＯＥ与ＨＤＬ－Ｃ、ＬＤＬ－Ｃ、ＴＣ、ＴＧ、ＡＰＯＡＩ、ＡＰＯＢ（１００）逐一进行相关比较，结果发现：脑动脉硬化症病人（ＣＡＳ）血清ＡＰＯＥ、ＬＤＬ－Ｃ、ＴＣ、ＴＧ、ＡＰＯＢ（１００）明显高于正常对照组（Ｐ＜０．０１），ＨＤＬ－Ｃ显著低于正常对照组（Ｐ＜０．０１），ＡＰＯＡＩ无明显变化（Ｐ＞０．０５），且ＡＰＯＥ与ＨＤＬ－Ｃ呈负相关；与ＬＤＬ－Ｃ、ＴＣ、ＴＧ、ＡＰＯＢ（１００）呈正相关；与ＡＰＯＡＩ无直线相关关系。提示ＡＰＯＥ可做为诊断脑动脉硬化症的重要指标。     

左旋咪唑迟发性脑病免疫功能的研究

用间接免疫荧光法测定４８例左旋咪唑迟发性脑病（ＬＩＤＥ）患才外周血淋巴细胞亚群，同时用ＩＣＳ－Ⅱ分析仪以速率散射比浊法检测患者血清和脑脊液（ＣＳＦ）配对标本的部分体液免疫指标。结果表明：ＬＩＤＥ组ＣＤ３、ＣＤ４、ＣＤ２５、ＣＤ４／ＣＤ８比值均显著高于对照组，ＣＤ８低于对照组（Ｐ〈０．００１）。血清和ＣＳＦＩｇＧ、ＩｇＡ、ＩｇＭ及ＩｇＧ鞘内合成率（ＩｇＧ－Ｓｙｎ）亦均明显高于对照组（Ｐ〈０．００１）     

血清ApoE对脑动脉硬化症的诊断价值

本文观察４２例脑动脉硬化症患者与正常对照组４４例，对其血清ＡｐｏＥ和ＨＤＬ－Ｃ、ＬＤＬ－Ｃ、ＴＣ、ＴＧ、ＡｐｏＡＩ、ＡｐｏＢ１００２６含量进行测定，并将ＡｐｏＥ与ＨＤＬ－Ｃ、ＬＤＬ－Ｃ、ＴＣ、ＴＧ、ＡｐｏＡＩ、ＡｐｏＢ１００逐一进行相关比较，结果发现：脑动脉硬化症病人血清ＡｐｏＥ、ＬＤＬ－Ｃ、ＴＣ、ＴＧ、ＡｐｏＢ１００明显高于正常对照组（Ｐ〈０．０１），ＨＤＬ－Ｃ显著低于正常对照组（Ｐ〈０．０１）     

癫痫患儿的免疫功能及免疫球蛋白辅助治疗的初步研究

目的：探讨癫痫患儿的免疫功能状态及免疫球蛋白辅助治疗的疗效。方法：测定５４例癫痫患儿血中ＩｇＧ、ＩｇＡ、ＩｇＭ、Ｓ３及Ｔ细胞亚群，与正常对照组比较；对１４例常规抗癫痫治疗效果不佳者加用免疫球蛋白辅助治疗，观察疗效。结果：癫痫患儿血清ＩｇＧ降低（Ｐ＜０．０５），ＩｇＡ降低（Ｐ＜０．０１），ＩｇＭ及Ｃ３正常，ＣＤ３、ＣＤ４降低（Ｐ＜０．０５），ＣＤ８升高（Ｐ＜０．０１），ＣＤ４／ＣＤ８降低（Ｐ＜０．０５），免疫球蛋白辅助治疗有效率５７．２％。结论：癫痫患儿存在免疫功能紊乱，提示免疫机制参与了癫痫发病机制；免疫球蛋白辅助治疗癫痫有效。     

抗心磷脂抗体与偏头痛的关系

采用酶联免疫吸附法（ＥＬＩＳＡ）检测８９例偏头痛患者和６２例健康人血清中ＩｇＧ、ＩｇＡ和ＩｇＭ３种类型抗心磷脂抗体（ＡＣＬ）。结果表明患者组３种类型ＡＣＬ指数均显著高于对照组（Ｐ＜０．０５，Ｐ＜０．０１），其中３５例具有一种类型以上ＡＣＬ阳性（３９．３％），以ＩｇＧ型阳性为主。而且女性患者ＡＣＬ阳性率显著高于男性。提示偏头痛的发病与ＡＣＬ生成有一定关系。     

重症肌无力患者血清IgG-乙酰胆硷受体抗体亚型研究

目的 探讨重症肌无力（ＭＧ）患者血清ＩｇＧ－乙酰胆硷受体抗体（ＡＣｈＲＡｂ）亚型的分布规律及其临床意义。方法 采用ＡＢＣ－ＥＬＩＳＡ法检测４３例ＭＧ组和２５例临床对照组、２０例正常对照组血清中ＩｇＧ－ＡＣｈＲＡｂ亚型ＩｇＧ１－４。结果 ＭＧ组与两对照组相比ＩｇＧ１和ＩｇＧ４亚型抗体无显著差别,ＩｇＧ２亚型抗体显著升高（Ｐ〈０．０５）,ＩｇＧ３亚型抗体显著降低（Ｐ〈０．０５）;ＭＧ组各临床类型间各亚型抗体无显著差别。结论 ＩｇＧ－ＡＣｈＲＡｂ亚型以ＩｇＧ２活性为主,但未显示与ＭＧ临床类型有关。     

脑动脉硬化的脑电图,脑电地形图经颅多普勒超声的对照研究

目的 探讨脑电图（ＥＥＧ）、脑电地形图（ＢＥＡＭ）及经颅多普勒超声（ＴＣＤ）三项检查联合应用对脑动脉硬化的诊断价值。方法 ２０８例临床诊断为脑动脉硬化的病人,均在发病一月内行ＥＥＧ、ＢＥＡＭ及ＴＣＤ检查。结果 ＥＥＧ异常７４例,ＢＥＡＭ异常１２５例住院ＴＣＤ异常率为１００％。ＥＥＧ与ＢＥＡＭ比较（Ｘ＾２＝２５．０６,Ｐ〈０．０１）。有非常显著差异;ＢＥＡＭ与ＴＣＤ比较（Ｘ＾２＝４．１２,Ｐ〈０．０     

精神分裂症免疫功能紊乱机理的研究

为探讨精神分裂症免疫功能紊乱的机理，检测了２８例精神分裂症患者外周血Ｔ细胞亚群、Ｂ细胞百分率及外周血单个核细胞白细胞介素（ＩＬ－２）、白细胞介素－４（ＩＬ－４）的诱生能力。发现患者组外周血全体Ｔ细胞（ＣＤ＋３）及辅助Ｔ细胞（ＣＤ＋４）均值明显低于对照组，ＩＬ－２诱生能力低下而ＩＬ－４诱生能力、血清总ＩｇＥ含量明显增高，与正常对照组相比有显著性差异。提示精神分裂症患者免疫功能紊乱主要表现为ＴＨ１细胞减少，ＴＨ２细胞相对或绝对增多。     

猴实验性变态反应性脑脊髓炎致敏前后猴脑脊液IgG指数和IgG合成率的检测及意义

目的为了研究体液免疫在实验性变态反应性脑脊髓炎（ＥＡＥ）中的作用，方法采用Ｂｅｋｍａｎｎ免疫分析仪和ＭｏｎａｒｃｈＰｌｕｓ生化仪对１０只实验性变态反应性脑脊髓炎（ＥＡＥ）食蟹猴脑脊液（ＣＳＦ）ＩｇＧ指数和ＩｇＧ合成率进行了发病前后自身对照检测。结果致敏前正常猴ＣＳＦＩｇＧ指数为０．３１０±０．１０１，致敏后ＩｇＧ指数为０．７４５±０．３０６；致敏前ＩｇＧ合成率为－４．６４±３．２９，致敏后ＩｇＧ合成率为３２．７２±５２．７３。致敏前后ｃｓｆＩｇＧ指数和ＩｇＧ合成率的差异有非常显著的意义（Ｐ＜０．０１）。两者致敏前后的改变与ＥＡＥ症状程度不完全一致。结论体液免疫在ＥＡＥ的发生中起重要作用。     

Serum and CSF immunological findings in ALS

Serum and CSF immunological findings were analysed in 37 patients with amyotrophic lateral sclerosis (ALS). ALS patients had significantly higher mean values of serum IgG and complement component C4 and significantly lower mean value of total haemolytic titre of complement (THC) compared with normal controls. Incidence of immune complexes (ICs) was significantly higher in sera of ALS patients than in normal controls. There was no significant difference regarding mean serum levels of IgM, IgA, and complement components C3 and Factor B between patients and controls. The blood-brain barrier (BBB) damage was found in 46% of patients. Intrathecal IgG synthesis was detected in six patients (16%). These results support the hypothesis of immune system involvement in ALS.     

Susceptibility gene for stroke or cerebral infarction in the Han population in Hunan Province of China

The scavenger receptor class B type I gene can protect against atherosclerosis; a mononucleotide polymorphism is associated with differences in blood lipid metabolism, postprandial serum lipid levels, insulin resistance, coronary artery disease and familial hyperlipidemia. In this study, the scavenger receptor class B type I gene exon 1 G4A gene polymorphism in atherosclerotic cerebral infarction patients, cerebral hemorrhage patients and normal controls was detected using the polymerase chain reaction-restriction fragment length polymorphism method. The results showed that the GA + AA genotype frequency of scavenger receptor class B type I gene G4A in atherosclerotic cerebral infarction patients was similar to that in cerebral hemorrhage patients and normal controls; however, the A allele frequency was significantly lower than that in normal controls. The serum level of high-density lipoprotein cholesterol in patients with the scavenger receptor class B type I gene G4A GA + AA genotype was significantly higher, while the serum level of low-density lipoprotein cholesterol was significantly lower than that in patients with the GG genotype, in both the atherosclerotic cerebral infarction and cerebral hemorrhage groups. The serum level of high-density lipoprotein cholesterol in patients with the scavenger receptor class B type I gene G4A GA + AA genotype was significantly higher, while the serum levels of low-density lipoprotein cholesterol and total cholesterol were significantly lower than those in normal controls with the GG genotype. Our experimental results suggest that the G4A polymorphism of the scavenger receptor class B type I gene is a possible predisposing risk factor for atherosclerotic cerebral infarction, and that it has no association with cerebral hemorrhage in the Han population in Hunan province of China. The A allele is possibly associated with the metabolism of high-density and low-density lipoprotein cholesterol.     

脑血管疾病患者血清TNF,IL—8的变化及临床意义

目的观察脑血管病患者血清肿瘤坏死因子（TNF）、白细胞介素-08（IL－8）水平的动态变化。方法采用ELISA法分别测定95例脑血管病患者起病＜1周及≥4周的血清TNF、IL－8水平。结果脑血管病患者血清NNF、IL－8水平较正常对照组增高，起病＜1周者血清TNF、IL－8水平较≥起病4周者升高显著；起病≥4周者脑梗死组血清TNF、IL-8和脑出血组TNF有明显下降，但仍高于正常对照组，脑出血组IL－8与正常对照组无明显差异。结论血清IL－8、TNF水平的动态监测对脑血管疾病（CVD）发生、发展及其预后判断具有一定预测价值。     

雌激素对绝经后妇女脑梗死及血脂水平的影响

目的探讨雌激素对绝经后妇女脑梗死及血脂水平的影响。方法 用放射免疫分析法和全自动生化分析仪测定50例绝经后妇女脑梗死患者及24例正常人血清E2、TC、TC、HDLC、LDL-C水平。结果 绝经后老年与非老年组脑梗死患者血清E2和HDLC水平均明显低于对照组,而TC、TC、LDLC水平均明显高于对照组(P<0.05~P<0.01)。上述各指标,以老年组改变为最明显,与非老年组相比有显著性差异(P<0.05)。同时老年组有多灶梗死者也明显多于非老年组(P<0.05)。相关分析,E2与IC、IC、LDLC呈负相关,与HDL-C水平呈正相关。结论 绝经后妇女脑梗死患者血清雌激素水平降低是导致脂代谢紊乱及脑梗死发生的主要危险因素。     

精神分裂症患者及其亲属免疫学研究

目的 :了解散发性首发精神分裂症患者及其一级亲属免疫球蛋白及补体成份与正常人是否存在差异。　方法 :用免疫透射比浊法测精神分裂症患者及其一级亲属及健康者血清中免疫球蛋白及补体成份的含量 ,并相互比较。　结果 :精神分裂症患者及其一级亲属IgA、IgG及C4显著高于正常人(P <0 .0 5～ 0 0 1)。　结论 :精神分裂症患者及其一级亲属存在同样免疫学异常 ,遗传因素可能是构成精神分裂症免疫学异常的基础     

Immunoglobulin k/Λ Ratios in Migraine and Tension-Type Headache

Abstract: The possibility of immunological mechanisms causing headaches has been proposed in the past. To investigate the immunological system activation in patients with chronic headaches, we evaluated the k/Λ ratios of immunoglobulins in 40 : patients with migraine and 49 : patients with tension-type headache. Nineteen healthy volunteers composed the control group. The serum k and Λ levels of immunoglobulins were determined by using the enzyme-linked immunosorbent assay (ELISA) techniques. The k/Λ ratios of IgG in the patients with tension-type headache were sigaiflcantly higher than those in the controls. The k/Λ ratios of IgA and IgM in the patients with headaches were higher than those in the controls, but they were not statistically significant. The total concentrations of IgG, IgA and IgM were significantly higher in the patients with migraine. In the patients with tension-type headache, the total concentrations of IgG and IgA were sigaificantly higher than those in the controls. The high levels of k/Λ ratios of IgC in the patients with tension-type headache and the increase in the total concentrations of immunoglobulins in the patients with migraine and tension-type headache, observed in this study, suggest that the humoral immunological system activation might exist, and it might be related to the etiology of tension-type headache and migraine.     

Respiratory disease and nasal immunoglobulin concentrations in phenytoin-treated epileptic patients

Symptoms of respiratory tract disease were recorded for half a year in 32 epileptic patients receiving phenytoin, and in 25 controls. There were 16 patients with normal IgA concentration in serum and nasal secretion, and 16 with a reduced concentration of IgA either in serum or in nasal secretion, or in both. Both groups of patients had significantly more frequent respiratory symptoms than did the controls ( P < 0.01). There was no difference when the patient group with decreased IgA concentrations was compared to that with normal IgA levels. All the four patients with IgA deficiency both in serum and nasal secretion had, however, more frequent symptoms than any of the controls. There was no difference regarding respiratory tract disease in patients taking phenytoin only, compared to those combining phenytoin and other anticonvulsants. IgG and IgM levels in nasal secretion showed no direct relationship to the frequency of respiratory symptoms.     

精神分裂症免疫功能与血清5-羟色胺的研究

目的:研究阴性型和阳性型精神分裂症患者免疫功能和神经生化物质改变情况及其变化规律.方法:选择阴性型和阳性型精神分裂症患者各20例以及20名正常对照者,抽取静脉血检测T细胞亚群,主要免疫球蛋白和补体C3、C4水平,和血清5-羟色胺(5-HT)水平.结果:阴性型精神分裂症患者CD 3下降,阳性型CD 3、CD 4则升高;IgG、IgA水平2种类型精神分裂症患者均显著降低;5-HT水平阳性型精神分裂症患者显著升高,阴性型精神分裂症患者显著降低.结论:精神分裂症患者伴随有免疫功能的改变,不同类型的精神分裂症其免疫应答参与机制也有不同.     

早期肠内营养对重型颅脑损伤病人免疫功能及并发症的影响

目的探讨重型颅脑损伤病人早期实施肠内营养对免疫功能及并发症的影响。方法对168例重型颅脑损伤病人(GCS≤8分)半随机分为肠内营养组(EN组)和肠外营养组(PN组),每组84例。用免疫组化法测定两组患者在入院后10d血清中IgG、IgA、IgM及IgE含量及T淋巴细胞亚群CD4+、CD8+、CD4+/CD8+值,对比两组的免疫功能变化。结果重型颅脑损伤后病人免疫功能明显下降,而EN组患者血清中的IgG、IgA、IgM显著高于PN组(P0.05);CD4+水平及CD4+/CD8+比值明显高于PN组(P0.05);IgE明显低于PN组(P0.05)。EN组的并发症发生率明显低于PN组(P0.05)。结论重型颅脑损伤病人可导致机体免疫功能下降,早期肠内营养支持可提高人体免疫功能,减少并发症的发生。