严重颅脑外伤对机体免疫功能的影响及其临床意义  

Severe Head Injuries Affecting Immune Function and Their Clinical Meaning

作　　者：钟述猷[1] 石涛 王明璐[2] 张赛[3] 符磊[1] 阎欢[1] 邢娜[1] 

机构地区：[1]天津医科大学总医院免疫科,300052 [2]天津医科大学总医院神经外科,300052 [3]天津环湖医院神经外科

出　　处：《天津医药》1999年第1期12-14,共3页Tianjin Medical Journal

基　　金：天津市科委资助

摘　　要：报告 ３７例严重颅脑外伤患者ＰＢＬ亚群变化及细胞因子ＩＬ－２、ｓＩＬ－２Ｒ、ＩＬ－６、ＩＬ－８、ＴＮＦα和Ｇ－ＣＳＦ的变化。脑外伤组ＣＤ_３~＋、ＣＤ_４~＋和ＣＤ_４~＋ ／ＣＤ_８~＋比值下降，ＣＤ~＋_８、ＣＤ_(２５)~＋均显著上升。经促分裂原ＰＨＡ刺激培养后，ＰＢＬ亚群的变化均明显低于对照组。脑外伤组ＩＬ－２下降，ＴＮＦα、ＩＬ－６及ＩＬ－８、ｓＩＬ－２Ｒ明显上升（Ｐ＜０．０１或Ｐ＜０．０５）。脑外伤感染亚组早期上述细胞因子已有明显改变。提示ＣＤ_４~＋、ＣＤ_(２５)~＋和ＩＬ－２、ＴＮＦα及ＩＬ－６的测定，对于早期判断脑外伤并发感染以及采取相应的防治措施具有重要的临床意义。Various T lymphocyte subsets in PBL and levels of IL-2, sIL-2R, IL-6, IL-8, TNFα and G-CSF were detected in 37 patients with severe head injury CD_3^+, CD_4^+, and ratio of CD_4^+ /CD_8^+ decreased, and CD_8^+, CD_(25)^+ increased significantly. After stimulated by mitogen PHA, various T lymphocyte subsets were significantly lower than health subjects, IL-2 level decreased, and levels of TNFα, IL-6, IL-8, sIL-2R increased obviously(P < 0. 01 or P < 0. 05 ). In early infectious period, the cytokines above-mentioned had varied obviously also. The results showed that the detection of CD_4^+, CD_(25)^+, IL-2, TNFα and IL-6 had important clinical significance in diagnosing and treating severe head injuries combined with infection.

关 键 词：颅脑损伤 免疫功能 T细胞亚群 白细胞介素 TNF 

分 类 号：R651.150.3[医药卫生—外科学]