颅脑损伤开颅术患者颅内压变化与Th17/Treg平衡的关系  

The relationship between the change of intracranial pressure and the balance of Th17/Treg in patients with craniocerebral injury undergoing craniotomy

作　　者：胡亚伟[1] 韩光魁[1] Hu Yawei;Han Guangkui(Neurosurgery Department,Affiliated Hospital of Jining Medical College,Jining 272200,China)

机构地区：[1]济宁医学院附属医院神经外科,山东272200

出　　处：《国际医药卫生导报》2020年第19期2920-2925,共6页International Medicine and Health Guidance News

摘　　要：目的探讨颅脑损伤开颅术患者颅内压变化与Th17/Treg平衡的关系。方法收集开颅手术治疗的颅脑损伤患者42例(观察组),并收集同期健康体检者40例作为对照,对比观察组术前外周血Th17/Treg细胞、IL-17、IL-10水平与对照组的差异;分析观察组患者外周血Th17/Treg细胞、IL-17、IL-10水平在术前、术后1~7 d的变化及脑脊液Th17/Treg细胞、IL-17、IL-10水平在术后1~7 d的变化;分析观察组患者颅内压变化与外周血Th17/Treg细胞、IL-17、IL-10水平的相关性。结果与对照组相比,观察组术前外周血Th17细胞、IL-17水平明显升高,Treg细胞、IL-10水平明显下降(均P<0.05)。观察组患者术后1~7 d时外周血中Th17细胞、IL-17水平逐渐下降,Treg细胞、IL-10水平逐渐升高(均P<0.05),术后7 d时恢复至正常。观察组患者术后1~7 d时脑脊液中Th17细胞、IL-17水平逐渐下降,Treg细胞、IL-10水平逐渐升高(均P<0.05)。与术前相比,观察组患者术后1 d、2 d、3 d、4 d、5 d、6 d、7 d时的颅内压逐渐下降(均P<0.05);术后7 d时颅内压正常。外周血Th17细胞、IL-17与颅内压呈正相关(r=0.541、0.553,均P<0.001),Treg细胞、IL-10水平与颅内压呈负相关(r=﹣0.576、﹣0.572,均P<0.001)。脑脊液Th17细胞、IL-17与颅内压呈正相关(r=0.612、0.592,均P<0.001),Treg细胞、IL-10水平与颅内压呈负相关(r=﹣0.596、﹣0.607,均P<0.001)。结论颅脑损伤开颅术患者颅内压变化与Th17/Treg平衡密切相关,可通过动态监测患者外周血或脑脊液中Th17/Treg细胞及相关细胞因子来评估颅内压变化,这对减少有创颅内压监测、降低相关并发症风险、减少患者医疗费用具有重要意义。Objective To explore the relationship between the change of intracranial pressure and the balance of Th17/Treg in patients with craniocerebral injury undergoing craniotomy.Methods 42 patients with craniocerebral injury treated by craniotomy were included into the observation group,and 40 healthy people during the same period were collected as the control group.The preoperative levels of Th17/Treg cells,IL-17,and IL-10 in the peripheral blood in the observation group were compared with those in the control group;the changes of the levels of Th17/Treg cells,IL-17,and IL-10 in the peripheral blood in the observation group before operation and at 1-7 days after operation and the changes of the levels of Th17/Treg cells,IL-17,and IL-10 in the cerebrospinal fluid at 1-7 days after operation were analyzed;the correlation between the intracranial pressure and the levels of Th17/Treg cells,IL-17,and IL-10 in the peripheral blood in the observation group were analyzed.Results Compared with the control group,the levels of Th17 cells and IL-17 in the peripheral blood in the observation group were significantly higher,and the levels of Treg cells and IL-10 were significantly lower(all P<0.05).In the observation group,the Th17 cells and IL-17 in the peripheral blood gradually decreased,Treg cells and IL-10 gradually increased,and returned to normal on the 7th day after operation(all P<0.05).The levels of Th17 cells and IL-17 in the CSF of the patients in the observation group decreased gradually from the 1st day to the 7th day after operation,and Treg cells and IL-10 increased gradually from the 1st day to the 7th day after operation(all P<0.05).Compared with that before operation,the intracranial pressure in the observation group decreased gradually at 1-7 days after operation(all P<0.05),and the intracranial pressure returned to normal on the 7th day after operation.Th17 cells and IL-17 in the peripheral blood were positively correlated with intracranial pressure(r=0.541,0.553;both P<0.001),while Treg cells and IL-10 were ne

关 键 词：颅脑损伤 标准大骨瓣减压术 Th17/Treg平衡 颅内压 

分 类 号：R651.15[医药卫生—外科学]