动脉瘤蛛网膜下腔出血患者外周血淋巴细胞程序性死亡受体1表达特性及意义的研究  

The expression characteristics and significance of peripheral blood lymphocyte programmed death-1 in patients with aneurysmal subarachnoid hemorrhage

作　　者：高毅 艾宇航[2] GAO Yi;AI Yu-hang(Department of ICU, Changsha Carnation Geriatric Hospital,Changsha 410200,China)

机构地区：[1]长沙康乃馨老年病医院重症医学科,410200 [2]中南大学湘雅医院重症医学科

出　　处：《临床神经病学杂志》2019年第5期368-371,共4页Journal of Clinical Neurology

摘　　要：目的通过观察动脉瘤蛛网膜下腔出血(aSAH)患者外周血淋巴细胞程序性死亡受体1(PD-1)的表达,探索其在aSAH患者中的表达特性及意义。方法选取aSAH患者共计21例,根据Glasgow昏迷量表(GCS)评分分为有神经症状组(GCS<15分,10例)和无神经症状组(GCS=15分,11例)。另选取6名健康志愿者作为正常对照组。使用流式细胞仪检测PD-1在各组患者外周血CD4^+和CD8^+ T淋巴细胞的表达情况,分析其特性及意义。结果无神经症状组PD-1^+CD4^+T淋巴细胞百分率和PD-1^+CD8^+ T淋巴细胞百分率均明显高于正常对照组,明显低于有神经症状组(均P<0.05)。aSAH患者PD-1^+CD4^+ T淋巴细胞百分率和PD-1^+CD8^+ T淋巴细胞百分率与GCS评分密切相关,Spearman系数分别为0.87和0.83(均P<0.05)。aSAH患者中,有神经症状组肺部感染发病率明显高于无神经症状组(P<0.05),且有肺部感染组PD-1^+CD4^+ T淋巴细胞百分率和PD-1^+CD8^+ T淋巴细胞百分率明显高于无肺部感染组(均P<0.05)。结论aSAH患者,特别是有神经症状的患者,CD4^+和CD8^+ T淋巴细胞PD-1表达强度明显增加,其表达强度增加与aSAH后神经症状严重程度和出血后肺部感染有相关性。Objective By observing the expression of peripheral blood lymphocyte programmed death-1(PD-1) in patients with aneurysm subarachnoid hemorrhage(aSAH), the expression characteristics and significance in patients with aSAH were explored. Methods A total of 21 patients with aSAH were selected and were divided into neurological symptoms group [Glaskow Coma Scale(GCS)<15, 10 cases] and non-neurological symptoms group(GCS=15, 11 cases) according to GCS. And 6 health human were selected as the control group. The expression of CD4^+ and CD8^+ T lymphocytes in peripheral blood of patients in each group was detected by flow cytometry, and its characteristics and significance were analyzed. Results The percentages of PD-1^+CD4^+ T lymphocyte and PD-1^+CD8^+ T lymphocytein of non-neurological symptoms group were significantly higher than those in control group, while significantly lower than those in neurological symptoms group(all P<0.05). The percentages of PD-1^+CD4^+ T lymphocyte and PD-1^+CD8^+ T lymphocytein were significantly correlated with the GCS score, and the Spearson coefficients were 0.87 and 0.83, respectively(all P<0.05). In the aSAH patients, the incidence of pulmonary infection in neurological symptoms group was significantly higher than that in non-neurological symptoms group(P<0.05), and the percentages of PD-1^+CD4^+ T lymphocyte and PD-1^+CD8^+ T lymphocytein in pulmonary infection group was significantly higher than that in non-pulmonary infection group(all P<0.05). Conclusion In patients with aSAH, especially those with neurological symptoms, the expression intensity of CD4^+ and CD8^+ T lymphocyte PD-1 is significantly increased, which is correlated with the severity of neurological symptoms after aSAH and pulmonary infection after hemorrhage.

关 键 词：动脉瘤 蛛网膜下腔出血 PD-1 CD4^+细胞 CD8^+细胞 

分 类 号：R743.35[医药卫生—神经病学与精神病学]