危重颅脑疾病患者应激性高血糖及细胞免疫功能与预后的关系

目的 探讨合并应激性高血糖的危重颅脑疾病患者血糖及细胞免疫功能与预后的关系.方法 检测83例合并应激性高血糖的危重颅脑疾病患者的细胞免疫功能指标,与健康对照组进行比较,并分析其与血糖的相关性.根据预后将83例患者分为死亡组和存活组,比较两组的血糖和细胞免疫功能指标,分析其与预后的相关性.结果 合并应激性高血糖的危重颅脑疾病患者CD3~+、CD4~+、CD4~+/CD8~+、CD16~++CD56~+显著低于对照组(P<0.05),血糖与CD3~+、CD4~+/CD8~+、CD16~++CD56~+呈负相关(相关系数r值分别为-0.348、-0.256、-0.301,P均<0.05).死亡组血糖显著高于存活组(P<0.05),CD4~6/CD8~+、CD16~++CD56~+显著低于存活组(P<0.05).结论 合并应激性高血糖的危重颅腩疾病患者存在一定程度的细胞免疫功能障碍,细胞免疫功能与血糖具有一定的相关性.两者均可影响患者预后.

Relationship of stress hyperglycemia and cellular immunity with prognosis in the patients with critically cerebral disease

Objective To investigate the changes of cellular immune function in the patients with critically cerebral disease and stress hyperglycemia, and its relationships with blood glucose level and prognosis.Methods The indicators of cellular immune function of 83 patients with critically cerebral disease and stress hyperglycemia were detected in order to compare with the normal controls,and the relationships with blood glucose levels were analyzed.83 patients were divided into survivors or non- survivors according to prognosis, their blood glucoses and cellular immune functions were compared, and the relationships with prognosis were analyzed.Results The results showed that CD3~+,CD4~+, CD4~+/CD8~+, CD16~++ CD56~+ were significantly lower than those in the normal controls(P <0.05),and CD3~+, CD4~+/CD8~+, CD16~++ CD56~+ were inversely related to blood glucose (r_1 =-0.348 ,r_2=-0.256, r_3=-0.301, P < 0.05).Blood glucose was higher in non- survivors than in survivors, while lower levels of CD4~+/CD8~+ ratio and CD16~+ + CD56~+ were found in non - survivors than in survivors (P < 0.05).Conclusion Stress hyperglycemia is associated with decreased cellular immune functions in the patients with critically cerebral disease, so blood glucose level and cellular immune function could be used as indicators to predict the prognosis.