脑外伤患者外周血CD34^+细胞及白细胞含量的动态变化  

Dynamic changes of peripheral blood CD34^+ cell count and white blood cell count in traumatic brain injury

作　　者：薛洪利[1] 王乃庚[1] 于春泳[1] 

机构地区：[1]沈阳军区总医院神经外二科,110840

出　　处：《中华临床医师杂志（电子版）》2011年第24期7256-7260,共5页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的动态观察并探讨不同损伤程度的颅脑损伤患者外周血白细胞及CD34+细胞的变化及同预后的关系,以及二者升高的机制和临床意义。方法选取30例脑外伤患者为研究对象,条件为:伤后6h内入院;通过询问病史、查体及辅助检查确定无其他部位严重损伤、感染及血液系统疾病;按入院时格拉斯哥昏迷评分(GCS)分为轻重两组,同时选择同期体检中心健康成年人15例作为对照组,向患者组家属及对照人员详细解释本研究的目的与方法,签署知情同意书。于入院第1、3、5、7、11、14天抽取患者组及对照组静脉血,用流式细胞仪检测外周血CD34+细胞含量;用血细胞分析仪常规检测白细胞计数,并对所得数据进行统计学分析,同时观察患者病情变化,追踪预后,按照患者预后不同情况分成死亡组和生存组,比较分析相关数据。结果 30例颅脑损伤患者外周血白细胞及CD34+细胞数量随病程的发展均有不同程度的升高,损伤越重、GCS评分越低、白细胞及CD34+细胞计数越高,预后越差,白细胞升高持续时间越长,预后愈差。外周血CD34+细胞在颅脑损伤后轻、重两组患者,各时间段逐步升高。重症患者自第3天与正常对照组出现统计学差异,明显高于轻症组患者,轻、重症两组间比较,在第7、11、14天有统计学差异(P<0.05)。白细胞计数在伤后迅速升高并逐步下降,同CD34+细胞变化未见正相关。结论外周血白细胞及CD34+细胞在颅脑损伤患者急性期均有不同程度的升高,计数增高越明显,持续时间越长,结果预后越差,可以作为判断其预后的一个指标。Objective To observe the dynamic changes of peripheral blood CD34+ cell count and white blood cell (WBC) count in brain injury patients,and explore their correlation with prognosis.Methods 30 patients with traumatic brain injury were admitted to our department for this study.Case inclusion criteria:admission within 6 hours after injury;no other serious injury,infection and blood system diseases.The patients were divided into 2 groups(mild group and severe group)according to Glasgow coma score.15 healthy adults were selected as control group.At day 1,3,5,7,11,14 in hospital,the CD34+ cell and WBC were counted by using flow cytometry and automatic blood cell analyzer.The patients were also divided into the death group and survival group according to the prognosis.The data were statistically analyzed.Results The peripheral blood CD34+ cell count and WBC count increased with the progress of the disease.The patients got worse prognosis while peripheral blood CD34+ cell and WBC count were higher and their duration were longer.CD34+ cell count:there was significant difference between severe group and control group at day 3,and there were significant differences between severe group and mild group at day 7,11,14(P<0.05).WBC count increased rapidly after injury and decreased gradually.There was no positive correlation between CD34+ cell count and WBC count.Conclusions The peripheral blood CD34+ cell count and WBC count increase differently in acute phase of traumatic brain injury,which are associated with the prognosis of patients.They can be used as indicators to determine the prognosis.

关 键 词：颅脑损伤 白细胞计数 抗原 CD34 预后 

分 类 号：R651.1[医药卫生—外科学]