[1]胡北泉,覃刚,魏风*,等.高血压患者脑出血后外周血T淋巴细胞亚群的动态变化及临床意义▲[J].内科,2020,15(02):135-138.[doi:DOI：10.16121/j.cnki.cn45-1347/r.2020.02.04]
　HU Beiquan,QIN Gang,WEI Feng,et al.Dynamic changes of peripheral blood T lymphocyte subsets in patients with hypertensive intracerebral hemorrhage and their clinical significance[J].Internal Medicine of China,2020,15(02):135-138.[doi:DOI：10.16121/j.cnki.cn45-1347/r.2020.02.04]
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高血压患者脑出血后外周血T淋巴细胞亚群的动态变化及临床意义▲()
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《内科》[ISSN:1006-6977/CN:61-1281/TN]

卷:
15卷
期数:
2020年02
页码:
135-138
栏目:
论著
出版日期:
2020-05-10

文章信息/Info

Title:
Dynamic changes of peripheral blood T lymphocyte subsets in patients with hypertensive intracerebral hemorrhage and their clinical significance
文章编号:
1673-7768（2020）02-0135-04
作者:
胡北泉; 覃刚; 魏风*; 兰杰; 吴静; 钟仕茂; 雷元华; 樊华声
南宁市第一人民医院神经外科，广西南宁市530021
Author(s):
HU Beiquan;  QIN Gang;  WEI Feng;  LAN Jie;  WU Jing;  ZHONG Shimao;  LEI Yuanhua;  FAN Huasheng
Department of Neurosurgery, the First People′s Hospital of Nanning, Nanning 530021, Guangxi, China
关键词:
高血压; 脑出血; T淋巴细胞亚群; CD4+细胞; CD8+细胞; 细胞免疫
Keywords:
Hypertension;  Intracerebral hemorrhage;  T lymphocyte subset;  CD4+ cell;  CD8+ cell;  Cellular immunity
分类号:
R 544.1
DOI:
DOI：10.16121/j.cnki.cn45-1347/r.2020.02.04
文献标志码:
A
摘要:
目的探讨高血压脑出血（HICH）患者发病后短期内（28 d）外周血T淋巴细胞亚群的变化情况，为临床治疗提供参考。方法选取在我院神经内科诊治的HICH患者90例、单纯高血压患者（高血压对照组）30例和在我院进行健康体检的志愿者30例（健康对照组）为研究对象，再按入院时GCS昏迷评分将90例HICH患者分为轻型组（12～15分，30例）、中型组（9～11分，30例）和重型组（3～8分，30例）。采用流式细胞术检测比较上述五组研究对象的外周血T淋巴细胞亚群水平，检测比较轻、中、重型三组HICH患者的外周血T淋巴细胞亚群动态变化情况。结果入院后第1天，HICH患者的CD4+细胞相对计数显著低于健康对照组和高血压对照组患者，且昏迷程度越重，相对计数越低（P＜0.05）；CD8+细胞相对计数显著高于健康对照组和高血压对照组患者，且昏迷程度越重，相对计数越高（P＜0.05）；CD4+/CD8+比值显著低于健康对照组和高血压对照组患者，且昏迷程度越重，CD4+/CD8+比值越低（P＜0.05）。入院治疗后，HICH患者的CD4+细胞相对计数逐渐下降，轻型组和中型组患者在第7天达最低水平，重型患者在第10天达最低水平；随后逐渐回升，在第28天时其水平与第1天时相当；HICH患者昏迷程度越重，CD4+细胞相对计数水平越低，轻、中、重型三组HICH患者的CD4+细胞相对计数比较差异有统计学意义（P＜0.05）。入院治疗后，HICH患者的CD8+细胞相对计数逐渐升高，轻型组和中型组患者在第7天达最高水平，重型组患者在第10天达最高水平；随后逐渐下降，在治疗第28天时其水平与第1天时相当；昏迷程度越重，CD8+细胞相对计数水平越高，轻、中、重型三组HICH患者比较差异有统计学意义（P＜0.05）。入院治疗后，HICH患者CD4+/CD8+比值逐渐下降，轻型组和中型组患者在第7天达最低水平，重型组患者在第10天达最低水平；随后逐渐回升，在第28天时其水平与第1天时相当，昏迷程度越重，CD4+/CD8+比值越低，轻、中、重型三组HICH患者比较差异有统计学意义（P＜0.05）。结论HICH患者发病后易出现细胞免疫功能紊乱，在第7～10天最为严重，发生感染的风险较高，对患者进行针对性治疗可能有助于减少其并发症的发生，改善预后。
Abstract:
ObjectiveTo explore the changes of peripheral blood T lymphocyte subsets in patients with hypertensive intracerebral hemorrhage (HICH) in the short term (28 days) of onset, and to provide the references for clinical treatment. MethodsA total of 90 HICH patients diagnosed and treated in Neurology Department of our hospital, 30 patients with simple hypertension (hypertension control group), and 30 volunteers (health control group) undergoing healthy examinations in our hospital were selected as the research objects. According to the GCS coma scores at admission, 90 HICH patients were divided into light group (12-15 points, 30 cases), medium group (9-11 points, 30 cases), and severe group (3-8 points, 30 cases). Flow cytometry was used to detect and compare the levels of T lymphocyte subsets in peripheral blood between the abovementioned five groups. The dynamic changes of T lymphocyte subsets in peripheral blood were detected and compared between the light medium and severe groups. ResultsOn the first day after admission, compared to the health control and hypertension control groups, HICH patients obtained significantly lower relative counts of CD4+ cells, with the more severe the coma, the lower the relative counts; moreover, higher relative counts of CD8+ cells presented to HICH patients, with the more severe the coma, the higher the relative counts, whereas lower CD4+/CD8+ ratio performed on HICH patients, with the more severe the coma, the lower the ratio of CD4+/CD8+ (P＜0.05). After admission, the relative counts of CD4+ cells in HICH patients gradually decreased. The patients in the light group and medium group reached to the lowest levels on the seventh day, and the patients in the severe group reached to the lowest level on the tenth day. Then the counts gradually picked up, and their levels on the twenty-eighth day were equivalent to those on the first day. The more severe the coma in HICH patients, the lower the relative counts of CD4+ cells. There was a statistically significant difference in the relative counts of CD4+ cells between the light group, medium and severe groups (P＜0.05). After admission, the relative counts of CD8+ cells in HICH patients gradually increased. The patients in the light group and medium group reached to the highest level on the seventh day, with the severe group in the highest level on the tenth day. Then the counts gradually decreased, and their levels on the twenty-eighth day were equivalent to those on the first day. The more severe the coma in HICH patients, the higher the relative counts of CD8+ cells. There was a statistically significant difference in the relative counts of CD8+ cells between the light, medium and severe groups (P＜0.05). After admission, the ratio of CD4+/CD8+ in HICH patients gradually decreased, with light group and medium group in the lowest level on the seventh day, and the severe group in the lowest level on the tenth day. Then the counts gradually picked up, and their levels on the twenty-eighth day were equivalent to those on the first day. The more severe the coma in HICH patients, the lower the relative counts of CD4+/CD8+ ratio. There was a statistically significant difference in the ratio of CD4+/CD8+ between the light, medium and severe groups (P＜0.05). ConclusionHICH patients are susceptible to cellular immune dysfunction after onset, which reached to the most serious on the seventh to tenth days, with a high risk of infection. Targeted treatment may help reduce the occurrence of complications and improve the prognosis of patients.

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备注/Memo

备注/Memo:
▲基金项目：南宁市科学研究与技术开发计划项目（20143319、20163133和20183040-2）；广西医药卫生自筹经费科研项目（Z20190684）
*通信作者：魏风，南宁市第一人民医院神经外科，电子邮箱 1320333805@qq.com
更新日期/Last Update: 2020-05-25