免疫球蛋白在病毒性脑膜炎中的应用价值及对患者T细胞亚群、炎症细胞因子水平的影响  

Evaluation of application value of immunoglobulin for patients with viral meningoencephalitis and its influence on T cell subsets and inflammatory cytokines

作　　者：鲍治诚[1] 夏雪龙[1] 吴亚平[1] 刘丹 

机构地区：[1]昆山市第一人民医院神经内科,江苏昆山215300 [2]南方医院神经外科,广东广州510515

出　　处：《海南医学院学报》2016年第19期2280-2282,2286,共4页Journal of Hainan Medical University

基　　金：2012年江苏昆山市社会发展科技计划项目(KS1235)~~

摘　　要：目的:观察免疫球蛋白在病毒性脑膜炎(VM)辅助治疗中的疗效,并初步探索其作用机制。方法:收集2011年9月~2016年4月来我院就诊的病毒性脑膜炎患者78例,根据入院顺序随机分为两组,对照组和观察组各39例。对照组采用阿昔洛韦常规治疗,观察组辅以免疫球蛋白,比较两组疗效差异及治疗前后两组血清、脑脊液T细胞亚群、炎症细胞因子水平差异。结果:观察组总有效率为92.31%,显著高于对照组(86.11%,P<0.05)。治疗后观察组血清、脑脊液CD3^+、CD4^+水平和CD4/CD8值显著高于对照组,而CD8^+则显著低于对照组(P<0.05)。治疗后观察组血清、脑脊液炎症细胞因子降钙素原(PCT)、γ-干扰素(INF-γ)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平显著低于对照组(P<0.05)。结论:免疫球蛋白能有效改善VM患者CD3^+、CD4^+、CD8^+水平,调节CD4/CD8平衡,抑制Th1细胞因子的合成和分泌,从而发挥辅助阿昔洛韦治疗病毒性脑膜炎的疗效。;Objective： To observe the effect of immunoglobulin in the adjuvant therapy of viral meningoencephalitis （VM）, and explore the mechanism preliminary. Methods： A total of 78 cases with VM in our hospital from September 2011 to April 2016 were chosen. According to the admission order, they were randomly divided into two groups, the control group and observation group, 39 cases in each group. The control group was taken with acyclovir conventional therapy, and the observa- tion group was supplemented by immunoglobulins. The differences of effect between the two groups were compared, and the serum and cerebrospinal fluid levels of T cell subsets and inflammatory cytokines between the two groups before and after treatment were compared. Results： The total effective rate of the observation group was 92.31% and significantly higher than that in the control group of 86.11% （P〈0.05）. The serum and eerebrospinal fluid levels of T cell subsets CD3＋ ,CD4＋ and CD4＋/CD8＋ were significantly higher than those in the control group, while the CD8＋ was significantly lower than that in the control group （P〈0,05）. The serum and cerebrospinal fluid levels of inflammatory cytokines PCT, INF-γ, IL-6 and TNF-αwere all significantly lower than those in the control group （P〈0.05）. Conclusions： Immunoglobulin can effectively improve the level of CD3＋ , CD4＋ and VM in CD8 patients, adjust the CD4/CD8 balance, and inhibit synthesis and secretion of Thlcytokines, so as to play the assistant effects of acyclovir in the treatment of VM.

关 键 词：病毒性脑膜炎 阿昔洛韦 免疫球蛋白 T细胞亚群 炎症细胞因子 

分 类 号：R512.3[医药卫生—内科学]