蚌埠医学院学报
蚌埠醫學院學報
방부의학원학보
ACTA ACADEMIAE MEDICINAE BENGBU
2015年
5期
624-626
,共3页
颅脑损伤%T淋巴细胞亚群%流式细胞仪%免疫%感染
顱腦損傷%T淋巴細胞亞群%流式細胞儀%免疫%感染
로뇌손상%T림파세포아군%류식세포의%면역%감염
craniocerebral injury%T lymphocyte subsets%flow cytometry%immune%infection
目的：：探讨重型颅脑损伤后T淋巴细胞亚群变化规律,为进行免疫干预预防感染提供参考依据。方法：选择单纯重型颅脑损伤格拉斯哥昏迷评分≤8分的患者30例为观察组,同期单纯轻型颅脑损伤格拉斯哥昏迷评分=14~15分患者30例为对照组。采用免疫荧光三色标记流式细胞仪对2组患者伤后第1、3、7和14天外周血T淋巴细胞亚群进行检测。结果：与对照组比较,观察组伤后第1天CD3、 CD4、CD4/CD8开始下降,CD8升高,第3天CD3、 CD4、CD4/CD8明显下降,CD8明显升高,第7天开始恢复,第14天基本同正常水平,2组伤后第1、3和7天差异均有统计学意义(P<0.05~P<0.01)。而伤后第14天2组4项指标差异均无统计学意义(P>0.05)。观察组伤后第4天肺部感染73.3%,对照组无肺部感染,2组差异有统计学意义(P<0.01)。结论：重型颅脑损伤后T淋巴细胞亚群变化规律为伤后第1天开始下降,第3天下降明显,第7天开始恢复,第14天基本恢复到正常水平,可考虑重型颅脑损伤后进行免疫干预预防感染。
目的：：探討重型顱腦損傷後T淋巴細胞亞群變化規律,為進行免疫榦預預防感染提供參攷依據。方法：選擇單純重型顱腦損傷格拉斯哥昏迷評分≤8分的患者30例為觀察組,同期單純輕型顱腦損傷格拉斯哥昏迷評分=14~15分患者30例為對照組。採用免疫熒光三色標記流式細胞儀對2組患者傷後第1、3、7和14天外週血T淋巴細胞亞群進行檢測。結果：與對照組比較,觀察組傷後第1天CD3、 CD4、CD4/CD8開始下降,CD8升高,第3天CD3、 CD4、CD4/CD8明顯下降,CD8明顯升高,第7天開始恢複,第14天基本同正常水平,2組傷後第1、3和7天差異均有統計學意義(P<0.05~P<0.01)。而傷後第14天2組4項指標差異均無統計學意義(P>0.05)。觀察組傷後第4天肺部感染73.3%,對照組無肺部感染,2組差異有統計學意義(P<0.01)。結論：重型顱腦損傷後T淋巴細胞亞群變化規律為傷後第1天開始下降,第3天下降明顯,第7天開始恢複,第14天基本恢複到正常水平,可攷慮重型顱腦損傷後進行免疫榦預預防感染。
목적：：탐토중형로뇌손상후T림파세포아군변화규률,위진행면역간예예방감염제공삼고의거。방법：선택단순중형로뇌손상격랍사가혼미평분≤8분적환자30례위관찰조,동기단순경형로뇌손상격랍사가혼미평분=14~15분환자30례위대조조。채용면역형광삼색표기류식세포의대2조환자상후제1、3、7화14천외주혈T림파세포아군진행검측。결과：여대조조비교,관찰조상후제1천CD3、 CD4、CD4/CD8개시하강,CD8승고,제3천CD3、 CD4、CD4/CD8명현하강,CD8명현승고,제7천개시회복,제14천기본동정상수평,2조상후제1、3화7천차이균유통계학의의(P<0.05~P<0.01)。이상후제14천2조4항지표차이균무통계학의의(P>0.05)。관찰조상후제4천폐부감염73.3%,대조조무폐부감염,2조차이유통계학의의(P<0.01)。결론：중형로뇌손상후T림파세포아군변화규률위상후제1천개시하강,제3천하강명현,제7천개시회복,제14천기본회복도정상수평,가고필중형로뇌손상후진행면역간예예방감염。
Objective:To detect the change rules of T lymphocyte subsets in patients with severe craniocerebral injury to provide the basis in preventing infection by immunologic intervention. Methods:Thirty severe craniocerebral injury patients with glasgow coma score ( GCS)≤8 and 30 light craniocerebral injury patients GCS =14 to 15 were divided into the observation group and control group, respectively. The expressions of lymphocyte subsets(including CD3,CD4,CD8,CD4/CD8 T) of peripheral blood in two groups after 1, 3,7 d and 14 d of injury were detected using the immunofluorescent three-color flow cytometry. Results:Compared with the control group,the levels of CD3,CD4 and CD4/CD8 began to decrease,and the level of CD8 increased 1 d after injury in observation group. Compared with the control group, the levels of CD3, CD4 and CD4/CD8 decreased significantly, and the level of CD8 increased significantly 3 d after injury in observational group. The levels of lymphocyte subsets began to recover after 7 d of injury,and arrived at the normal level after 14 d of injury. The differences of the levels of lymphocyte subsets between two groups after 1 d,3 d and 7 d after injury were statistically significant(P<0. 05 to P<0. 01),and there was not statistical significance 14 d after injury(P>0. 05). The lung infection rates in the observation group and control group after 4 d of injury were 73. 3% and 0,respectively,the difference of which was statistically significant(P<0. 01). Conclusions:Decreasing on day 1,significant decreasing on day 3,recovering on day 7 and arriving at the normal level on day 14 are the change rules of T lymphocyte subsets in severe craniocerebral injury patients. The immunologic intervention can be used to prevent infection in severe craniocerebral injury patients.
