左右侧大脑中动脉急性脑梗死后白细胞变化及预后的比较  

Dynamic changes of leukocytes and prognoses of patients with right and left middle cerebral artery infarction： a comparative study

作　　者：鲍健[1] 陈素芹[1] 张丙俊[1] 张雷[1] 陆正齐[1] 

机构地区：[1]中山大学附属第三医院神经科,广州510630

出　　处：《中华神经医学杂志》2013年第8期801-805,共5页Chinese Journal of Neuromedicine

基　　金：国家自然科学基金（81271328）;广州市科技计划重大专项（2011Y200017）

摘　　要：目的 探讨不同侧大脑中动脉（MCA）急性脑梗死对免疫系统的不同影响. 方法 选择中山医科大学附属第三医院自2006年1月至2013年2月收治的99例急性MCA大面积梗死患者,按梗死部位分为左侧脑梗死组（n=51）和右侧脑梗死组（n=48）,分别对2组患者起病后第1天、第3天、第7天的外周血白细胞计数及各分类白细胞比例、1周内肺部感染情况、1周内体温、1个月或出院时患者美国国立卫生研究院卒中量表（NIHSS）评分和改良Rankin评分等进行比较. 结果 2组患者肺炎感染率、1周内体温情况、1月内NIHSS评分及改良Rankin评分差异均无统计学意义（P＞0.05）.未按肺炎分层时2组患者白细胞数量差异无统计学意义（P＞0.05）；按肺炎分层后,2组无肺炎患者中性粒细胞及淋巴细胞1周内变化趋势呈现出明显不同. 结论 未感染肺炎的左侧和右侧MCA脑梗死患者急性期白细胞变化趋势不完全相同,提示不同侧MCA脑梗死引起免疫抑制的机制可能不同.Objective To explore the effects of right and left middle cerebral artery （MCA） infarction on immune system of these patients.Method A total of 99 acute MCA infarction patients,admitted to our hospital from January 2006 to February 2013,were enrolled in this retrospective study.Based on the artery involved,these patients were divided into left MCA infarction group （n=51） and right MCA infarction group （n=48）.Such data,including dynamic changes of leukocytes （white blood cell count and ratio of each kind of white blood cells） on the 1st,3rd and 7th d of onset,pulmonary infection rate within 1 week of onset and NIHSS and improved Rankin scale scores assessed 1 month after onset/at discharge,were comparatively analyzed between these two groups.Results No significant differences on pulmonary infection rate,temperature within one week of onset,and NIHSS and improved Rankin scale scores assessed 1 month after onset were noted between the two groups （P〉0.05）.No statistic difference was found when comparing the different type ofleukocytes on the 1st,3rd and 7th d after stroke and the dynamic changes of leukocytes in the 1st week between the two groups （P〉0.05）.But the dynamic changes of neutrophils and lymphocytes in patients without pneumonia were different between the two groups.Conclusion MCA infarction patients have different variation tendency of leukocyte between the left and right side,which may indicate that the mechanism of post-stroke immunodepression is different when affect different MCA.

关 键 词：大脑中动脉 脑梗死 免疫抑制 白细胞 左侧 右侧 

分 类 号：R743.3[医药卫生—神经病学与精神病学]