卒中相关性肺炎血清炎症因子和外周血淋巴细胞亚群的分析  

Analysis of serum inflammatory factors and peripheral blood lymphocyte subsets in patients with stroke-associated pneumonia

作　　者：李琳[1] 刘玮[1] 洪畋[1] 刘佳妮 葛小金 王芳[2] LI Lin;LIU Wei;LIU Jia-ni;HONG Tian;GE Xiao-jin;WANG Fang(Department of Geriatrics,Wuhan Municipal Central Hospital,Wuhan,430014 China;Department of Neurology,Wuhan Municipal Central Hospital,Wuhan 430014,China)

机构地区：[1]武汉市中心医院老年科,430014 [2]武汉市中心医院神经内科,430014

出　　处：《中国临床神经外科杂志》2019年第12期740-742,共3页Chinese Journal of Clinical Neurosurgery

基　　金：武汉市卫计委医学科研项目(WX16D33)

摘　　要：目的探讨卒中相关性肺炎(SAP)病人血清炎症因子白细胞介素(IL)-1β、IL-6、IL-4、肿瘤坏死因子-α(TNF-α)的水平变化及其临床意义。方法选取2016年3月至2017年3月收治的48例SAP,根据A2D2S2L评分分为低危(0~2分,14例)、中危(3~9分,15例)、高危(≥10分,19例)三组。入院后次日清晨取空腹静脉血,应用流式细胞仪测定外周血T淋巴细胞亚群(CD3^+、CD4^+、CD8^+),应用酶联免疫吸附试验法检测血清炎症因子(IL-1β、IL-6、TNF-α、IL-4)。结果随着危险程度的增高,血清IL-1β、IL-6、IL-4、TNF-α水平均明显增高(P<0.05),外周血CD3^+和CD4^+细胞百分比显著增高(P<0.05)。低危组CD4^+/CD8^+显著高于高危组和中危组(P<0.05),而后两组无统计学差异(P>0.05);三组CD3^+/CD8^+均无显著差异(P>0.05)。结论血清炎症因子IL-1β、IL-6、TNF-α、IL-4以及T细胞淋巴亚群变化情况反映SAP病人的A2D2S2L评分,血清IL-1β、IL-4、IL-6、TNF-α与A2D2S2L评分呈正相关,T细胞亚群CD3^+、CD4^+百分比与A2D2S2L评分呈负相关。Objective To explore the changes of the levels of serum inflammatory factors and the peripheral blood lymphocyte subsets in patients with stroke-associated pneumonia(SAP). Methods Of 48 patients with SAP treated in our hospital from March, 2016 to March, 2017, 19 with A2 D2 S2 L score≥10 points were in high risk group, 15 with A2 D2 S2 L score 2~9 points in middle risk group and14 with A2 D2 S2 L score 0~2 points in the low risk group. The serum levels of interleukin(IL)-1β, IL-6, tumor necrosis factor-α(TNF-α) and IL-4 and the status of T cell subsets in peripheral blood were determined in the all the patients. Results The serum levels of IL-1β, IL-6, TNF-α and IL-4 were significantly higher in the high risk group than those in the middle risk group(P<0.05), which were significantly higher than those in the low risk group(P<0.05). The serum levels of CD3^+and CD4^+were significantly higher in the low risk group than those in the middle risk group(P<0.05), which were significantly higher than those in the high risk group(P<0.05).The ratio of CD4^+to CD8^+was significantly higher in the low risk group than that in the middle risk group and the high risk group(P<0.05),but there was insignificant difference in the ratio of CD3^+to CD8^+among the three groups(P>0.05). Conclusion It is suggested that the serum levels of Ⅰ L-1β, IL-6,TNF-α and IL-4 may be positively related to A2 D2 S2 L score, and the serum levels of CD3^+and CD4^+and the ratio of CD4^+to CD8^+were negatively related to A2 D2 S2 L score in the patients with SAP.

关 键 词：卒中相关性肺炎 淋巴细胞 炎症因子 外周血 

分 类 号：R743.3[医药卫生—神经病学与精神病学]