CAJ | 학술논문

目的探讨急性重症脑卒中患者单核细胞免疫抑制与C-反应蛋白(CRP)和纤维蛋白原(Fg)的关系,了解卒中患者免疫抑制的可能机制.方法研究连续入选的24h内入住神经重症监护病房(NICU)的急性脑卒中患者(53例),以同期神经内科普通病房住院的头晕患者(均经头颅MRI排除急性脑卒中)作为对照组(39例).检测脑卒中患者人院后第1、2、4、6和14天的单核细胞人类白细胞抗原-DR(HLA-DR)表达水平和卒中组、对照组入院后第2天CRP和Fg的浓度.采用GraphPad PRISM4.0 demo软件进行因素之间的关联分析.结果与对照组比较,卒中组CRP、Fg的水平增高,差异有统计学意义(P<0.05).卒中组CRP和Fg与不同时间点的单核细胞HLA-DR表达水平有不同程度的负相关性.CRP与入院后第2天HLA-DR表达负相关性最明显(r=-0.419,P=0.001).Fg与入院后第4天HLA-DR表达负相关性最明显(r=-0.434,P=0.001).结论急性重症脑卒中患者单核细胞免疫抑制机制与卒中后炎症反应有关.
목적 탐토급성중증뇌졸중환자단핵세포면역억제여C-반응단백(CRP)화섬유단백원(Fg)적관계,료해졸중환자면역억제적가능궤제.방법 연구련속입선적24h내입주신경중증감호병방(NICU)적급성뇌졸중환자(53례),이동기신경내과보통병방주원적두훈환자(균경두로MRI배제급성뇌졸중)작위대조조(39례).검측뇌졸중환자인원후제1、2、4、6화14천적단핵세포인류백세포항원-DR(HLA-DR)표체수평화졸중조、대조조입원후제2천CRP화Fg적농도.채용GraphPad PRISM4.0 demo연건진행인소지간적관련분석.결과 여대조조비교,졸중조CRP、Fg적수평증고,차이유통계학의의(P<0.05).졸중조CRP화Fg여불동시간점적단핵세포HLA-DR표체수평유불동정도적부상관성.CRP여입원후제2천HLA-DR표체부상관성최명현(r=-0.419,P=0.001).Fg여입원후제4천HLA-DR표체부상관성최명현(r=-0.434,P=0.001).결론 급성중증뇌졸중환자단핵세포면역억제궤제여졸중후염증반응유관.
Objective To explore the correlations between monocyte immunodepression andthe levels of C-reactive protein (CRP) and fibrinogen (Fg) in patients with severe acute stroke. MethodsThis prospective study involved 53 consecutive patients admitted in the neurological intensive care unit(NICU) within 24 h after stroke onset. Blood samples were collected serially on days 1, 2, 4, 6 and 14after stroke to determine monocytic HLA-DR expression using flow cytometry. CRP and Fg weredetected on day 2 after the admission, and Graph_Pad PRISM 4.0 software was used to analyze thecorrelations among the variables. Thirty-nine concurrent patients admitted in the general ward, whocomplained dizziness without magnetic resonance imaging evidence of acute stroke, were enrolled toserve as the control group. Results The levels of CRP and Fg in the stroke group were significantlyhigher than those in the control group (P<0.05). The CRP and Fg levels were both found to inverselycorrelate to monocytic HLA-DR expression at different observational points. The correlations of CRP andFg to HLA-DR expression were the most obvious on day 2 and 4 after admission (r=-0.419, P=0.001;r=-0.434, P=0.001), respectively. Conclusion Immunosuppression of the monocytes in patients withsevere acute stroke is probably associated with the inflammatory reaction after stroke.