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。

A Study on Immunoglobulin Serial Parameters of Peripharal Blood and Cerebrospinal Fluid of Arteriosclerosis Cerebrovascular Disease

Serial cerebrospinal fluid (CSF) and peripheral blood (PB)immunoglobulin , complement and CSF albumin (CSF Alb) parameters were studied in 34 patients with a well-established diagnosis of arteriosclerosis cerebrovascular disease (ACVD) . in which there were 16cases of brain hemorrhage and 18 cases of brain ischemia. The results were compared with those of 20 "normal" patients with arteriosclerosis but no other disease. (age distributions were between 45 and 83 years old) in PB and CSF. Lumbar puncture was usually carried out on 1.5-6 days after acute occurrence. Serum was always taken simultaneously on the second day. IgG, IgA, IgM and C3,C4,CH50 were measured simultaneously in CSF and serums.The CSF Alb and the CSF IgG/S IgG ratio were also measured. It was shown that there was a significant increase in IgG,C3,C4 and CH50 of patients with ACVD,and those of patients were higher than those of normals,however there were no significant difference between hemorrhage group and ischemia.IgA and IgM were consistant in 3 groups. It was shown that there are IgG in CSF increase of patients with ACVD,the CSF-IgG and CSF IgG/S IgG ratio and CSF Alb of patients were higher than normals,and those of Hemorrhage group were higher than ischemia. The results demonstrated that there was an enhancement of humoral immunity in patients with ACVD, which may be one of immunopathological pathogeneses of pneumonic infection. The hemorrhage group had more acute damage to the bloodbrain-barrier (BBB) than the ischemia group. There was also a possibly of IgG synthesis within the central nervous system (CNS) which indicated immunological responsive reactions in CNS after acute brain tissue damage. Changes of these parameters were different in PB and CSF.This also reflected the specificity of neuroimmunology.