血清TREC及炎症指标监测颅脑创伤合并心衰患者感染免疫功能的探讨  

Use of Serum TREC and Inflammation Indexes for the Monitoring of the Immune Function in Patients with Traumatic Brain Injury and Heart Failure

作　　者：刘慎敏 龙瑞斌 朱惠 廖正俭[2] LIU Shenmin;LONG Ruibin;ZHU Hui;LIAO Zhengjian(Fujian Academy of Medical Sciences,Fujian Key Laboratory of Medical Testing,Fuzhou,350001,China;Department of Neurosurgery,Fujian Provincial Hospital,Fujian Medical University,Fuzhou,350001,China)

机构地区：[1]福建省医学科学研究院福建省医学测试重点实验室,福州市350001 [2]福建医科大学省立临床学院福建省立医院神经外科,福州市350001

出　　处：《医学分子生物学杂志》2020年第3期234-238,共5页Journal of Medical Molecular Biology

基　　金：福建省省属公益类科研院所专项(No.2017R1031-3)。

摘　　要：目的对颅脑创伤合并心衰患者并发感染后外周血炎症指标变化及机体免疫功能情况的监测,为临床诊疗提供思路与借鉴。方法选取2017年11月至2019年7月在福建省立医院神经外科诊治的40例颅脑损伤合并心衰后并发感染患者,分为轻度感染组、重度感染组,以医院同期颅脑损伤合并心衰未并发感染患者19名为对照组,比较各组外周血清PCT、IL七、WBC水平,以此评估患者感染严重程度;荧光定量PCR技术检测外周血中T细胞受体重排删除环(T cell receptor rearrangement excision circles,TREC)拷贝数,判断患者近期胸腺输出功能,评估机体免疫功能情况。结果颅脑创伤合并心衰患者中PCT、IL-6、WBC水平随着感染程度加重明显升高(P<0.05);与颅脑损伤合并心衰未并发感染患者外周血中TREC拷贝数相比,颅脑创伤合并心衰患者并发感染后外周血TREC均降低,重度感染组降低最明显(P<0.01)。结论通过监测颅脑创伤合并心衰并发感染患者外周血清PCT、K、WBC判断感染严重程度,检测外周血中T细胞受体重排删除环(TREC)拷贝数预测机体免疫功能状态,对颅脑创伤合并心衰感染患者预后有重要的预测价值。Objective The changes in inflammation indices in peripheral blood and immune function were monitored in patients with traumatic brain injury and heart failure to provide information for clinical diagnosis and treatment.Methods Forty patients with traumatic brain injury complicated with heart failure in Fujian Provincial Hospital were examined from November 2017 to July 2019.They were randomly divided into two groups:a mild infection group and a severe infection group.Nineteen patients of the same age who had brain injury complicated with heart failure but had no infection were included in control group.PCT,IL-6,and WBCs in the peripheral blood were detected in each group to evaluate the severity of infection.T cell receptor rearrangement circles(TREC)in peripheral blood were quantitatively detected by using real-time PCR to judge the patient*s recent thymic output function and assess the immune function.Results The levels of PCT,IL-6 and WBC counts in patients with traumatic brain injury and heart failure increased significantly in the severe infection group(P<0.05);TREC level decreased as compared with the control group and the level dropped most in the severe infection group(P<0.01).Conclusion Monitoring the levels of PCT,IL-6,and WBC count to determine the severity of infection and determining the TRECs copy number of peripheral blood are of great significance for the prognosis prediction in in patients with traumatic brain injury complicated with heart failure.

关 键 词：颅脑外伤 心衰 感染 炎症指标 T细胞受体重排删除环 

分 类 号：R392.[医药卫生—免疫学]