脑出血患者的免疫功能研究

摘要:目的　分析脑出血患者外周血T淋巴细胞亚群、免疫球蛋白的变化，探讨其在脑出血患者中的应用价值。方法　用流式细胞仪测定85例脑出血患者和50例对照组外周血T淋巴细胞亚群，采用免疫比浊法测定血清IgA、IgG、IgM含量。结果　脑出血患者全血CD8+明显高于健康对照组（t＝4.48，P＜0.05），而血CD3+、CD4+及CD4+/CD8+比值则显著低于健康对照组（t＝10.10；t＝7.82；t＝3.59，P＜0.05）。IgG、IgM水平均高于对照组（t＝6.32；t＝5.35；P＜0.05），而IgA水平2组无统计学差异（t＝0.58，P＞0.05）。神经损伤的损失越严重，CD3+、CD4+及CD4+/ CD8+比值越低（F＝7.84；F＝3.65；F＝1.32，P＜0.05）；CD8+ IgG、IgM水平越高，差异有统计学意义（F＝3.62；F＝2.23；F＝1.52，P＜0.05）。结论　脑出血患者细胞免疫功能降低，体液免疫功能增强。外周血T 细胞亚群和免疫球蛋白的检测对判断脑出血患者的病情、预后以及机体的免疫功能的观察有一定意义。

Clinical analysis of immune function in patient with cerebral hemorrhage

Abstract: Objective This work was to analyze the change in peripheral blood T-lymphocyte cell subsets and immunoglobulin in order to evaluate the value of such changes in the clinical diagnosis of cerebral hemorrhage. Methods Peripheral blood samples were collected from the cerebral hemorrhage patients and healthy people and measured for T-Lymphocyte subsets by BeckmanCoulter -EPICS-XL FlowCytometry (FCM). The level of IgA, IgG, IgM were detected by the immunoturbidimetric assay. Results Compared to the healthy people, the level of whole blood CD8+ was significantly higher (t=4.48, P<0.05), and levels of CD3+, CD4+ and CD4+-to-CD8+ ratio were significantly lower (t=10.10; t=7.82; t=3.59, P<0.05). The concentrations of IgG and IgM were higher in the patient group (t=6.32; t=5.35, P<0.05), whereas the IgA concentration showed no significant difference between the patient group and the control group (t=0.58, P>0.05). With increasing neural damage, the level of CD3+ and CD4+, and the CD4+/CD8+ ratio decreased (F=7.84; F=3.65; F=1.32, P<0.05), but the levels of CD8+, IgG and IgM increased (F=3.62; F=2.23; F=1.52, P<0.05). Conclusion In cerebral hemorrhage patients, the cellular immunity of decreased and humoural immunity increased. Determination of T cell subsets and immunoglobulin in the peripheral blood of patients with cerebral hemorrhage might be of some significance in the diagnosis and prognosis evaluation of this disease, and in the evaluation of patient immunity.