摘要
目的 :探讨颅脑损伤对患者细胞免疫功能的影响及其变化规律。方法 :随机选取伤后 2 4小时内入院的颅脑损伤患者 48例 (实验组 ) ,对照组选择同期住院的颅骨缺损修补术术前患者 9例 ,实验组患者按格拉斯哥昏迷评分法 (GCS)评分及预后分组后 ,在不同时间分别采集血清及血涂片标本。采用放射免疫法、双抗体夹心酶联免疫吸附法 (EL ISA)及碱性磷酸酶法 (APAAP)法分别检测患者血中白细胞介素 2 (IL 2 )、可溶性白细胞介素 2受体 (SIL 2 R)及 T淋巴细胞亚群。结果 :颅脑损伤后 2 4小时内患者血中 IL 2 ,T淋巴细胞 CD4亚群及 CD4/ CD8即开始显著下降 ,SIL 2 R及 CD8显著升高 ;GCS分值越低者 ,变化越明显 ,该变化在伤后第14日左右呈恢复趋势 ;重型颅脑损伤生存组与死亡组患者上述指标间存在显著性差异。结论 :颅脑损伤患者存在明显的细胞免疫功能抑制 ,且随创伤程度加重 ,细胞免疫抑制程度进一步加剧 ;伤后 2 4小时内 ,重型颅脑损伤患者的细胞免疫功能即出现明显抑制 ,至第 14日时呈恢复趋势。
Objective:To explore the changes in the cellular immunologic function in patients with cerebral injury.Methods:48 patients who were admitted to the hospital within 24 hours postinjury were randomly selected and 9 patients with skull defect were selected as the control.The patients were divided into groups in term of Glasgow coma score(GCS).Blood samples were collected accordingly and assayed using radioimmunoassay,sandwiched enzymelinked immunosorbent assay(ELISA) and alkaline phosphataseantialkaline phosphatase(APAAP) methods.Results:Blood interleukin2(IL2) concentration,T lymphocyte CD4 subpopulation and the ratio of CD4/CD8 in patients with craniocerebral injury decreased obviously within 24 hours while soluble interleukin2 receptor (SIL2R) and CD8 increased significantly.The lower the GCS,the more obvious were the changes in these parameters.The alteration was most obvious in nonsurvivors of severely injured group.These immunological indexes tended to return to normal level about fourteen days after injury.The indexes were of statistical significance among the patients with different outcome.Conclusions:Cellular immunity impairment exist in patients with head injury.The extent of cellular immunity suppression is correlated with the severity of the injury scaled by GCS.
出处
《中国危重病急救医学》
CAS
CSCD
2000年第5期293-295,共3页
Chinese Critical Care Medicine
基金
西安医科大学硕士研究生课题资助项目!(96048)
关键词
颅脑损伤
细胞免疫
IL-2
SIL-2R
T淋巴细胞亚群
craniocerebral injury
cellular immunity
interleukin-2
soluble interleukin-2 receptor
T lymphocyte subpopulation
