基于血液学生物标志物对卒中相关性肺炎的研究进展  

Advances in the Study of Stroke-Associated Pneumonia Based on Hematologic Biomarkers

作　　者：徐云瑀 赵智艳 尚正福 张颖[1] 缪薇[1] 

机构地区：[1]昆明医科大学第二附属医院神经内科,云南 昆明 [2]保山市第二人民医院神经内科,云南 保山

出　　处：《临床医学进展》2024年第6期227-234,共8页Advances in Clinical Medicine

摘　　要：卒中后肺部炎是脑卒中最常见的并发症,影响卒中患者预后与结局,由于临床早期识别SAP较为困难,因此,需要积极探索便捷、高特异性和高敏感性的血液生物标志物,以期早期识别SAP高风险患者,并尽快采用合理的治疗手段,避免卒中结局恶化。卒中诱导的免疫抑制是SAP的最主要发病原因。中风在大脑中产生强大的炎症联级反应,脑损伤后机体为保护脑组织进一步炎症损害,引起的免疫抑制减少炎症反应,细胞免疫功能快速持续下降,单核细胞和Th1细胞失活,Th介导的淋巴细胞减少,脾脏、胸腺和淋巴结免疫细胞凋亡增加,增加感染的风险。基于炎症免疫反应学说,越来越多的血液学生物标志物被发现与SAP的发生及进展密切相关,与传统的血液学感染指标,如CRP、PCT等比较,新型血液学生物标志物NLR、MLR、PLR、SII及T细胞亚群等具有简单易获得、可重复检测、更客观准确等优点。本文就新型血液学生物标志物对SAP的作用影响作一综述,以期为临床早期预测及诊断SAP提供新的手段。Post-stroke pulmonary inflammation is the most common complication of stroke, affecting the prognosis and outcome of stroke patients. Due to the difficulty in early clinical recognition of SAP, it is necessary to actively explore convenient, highly specific and highly sensitive blood biomarkers, so as to identify high-risk patients with SAP early and adopt reasonable treatment as soon as possible to avoid worsening stroke outcomes. Stroke induced immunosuppression is the main cause of SAP. Stroke produces a powerful inflammatory cascade in the brain. After brain injury, in order to protect the brain tissue from further inflammatory damage, the immune suppression caused by the brain reduces the inflammatory response, the rapid and continuous decline of cellular immune function, the inactivation of monocytes and Th1 cells, TH-mediated lymphocytopenia, and the increase of apoptosis of immune cells in the spleen, thymus and lymph nodes increase the risk of infection. Based on the theory of inflammatory immune response, more and more hematologic biomarkers have been found to be closely related to the occurrence and progression of SAP. Compared with traditional hematologic infection indicators such as CRP and PCT, The novel hematologic biomarkers NLR, MLR, PLR, SII and T cell subsets have the advantages of being simple, repeatable, objective and accurate. This article reviews the effects of novel hematologic biomarkers on SAP, in order to provide a new means for early clinical prediction and diagnosis of SAP.

关 键 词：卒中相关性肺炎 生物标志物 免疫抑制 淋巴细胞 

分 类 号：R73[医药卫生—肿瘤]