脑梗死合并感染患者血清皮质醇含量测定及其与神经功能、体液免疫、细胞免疫的相关性

Serum cortisol level in cerebral infarction patients with infection and its correlation with nerve function,humoral immunity and cellular immunity

目的:分析脑梗死合并感染患者血清皮质醇含量及其与神经功能、体液免疫、细胞免疫的相关性。方法:86例脑梗死患者根据是否合并感染分为观察组(脑梗死合并感染)40例、对照组(单纯脑梗死)46例。检测两组入院后即刻血清皮质醇、神经功能相关指标、体液免疫指标含量,以及外周血细胞免疫指标水平,进一步分析脑梗死合并感染患者血清皮质醇含量与以上病情相关指标的相关关系。结果:观察组血清皮质醇含量显著高于对照组;血清神经功能指标S100β、GFAP、Hcy、HO1含量显著高于对照组,IGF-1含量显著低于对照组;血清体液免疫指标IgA、IgM、IgG、C3、C4含量显著低于对照组;外周血细胞免疫指标CD3^+、CD4^+、CD54^+T淋巴细胞含量显著低于对照组,CD19^+T淋巴细胞含量及CD4^+/CD8^+水平均显著高于对照组;血流动力学指标rCBF、rCBV水平显著低于对照组,MTT、TTP、DLY水平显著高于对照组。脑梗死合并感染患者血清皮质醇含量与神经功能、体液免疫、细胞免疫等病情相关指标水平存在直接相关关系。结论:脑梗死合并感染患者的高皮质醇状态是神经功能损伤严重、免疫功能抑制的直观标志,可以作为远期疾病治疗指导、预后判断的可靠手段。

Objective： To analyze the serum cortisol level in cerebral infarction patients with infection and its correlation with nerve function, humoral immunity and cellular immunity. Methods： A total of 86 patients with cerebral infarction were di- vided into observation group （cerebral infarction combined with infection） （n = 40） and control group （cerebral infarction a- lone） （n = 46） according to the combination of infection. Serum content of cortisol, nerve function-related indexes and humoral immunity indexes as well as peripheral blood levels of cellular immunity indexes of two groups of patients were determined on admission, and the correlation between serum cortisol level and the above illness-related indexes in cerebral infarction patients with infection was further analyzed. Results.. Serum cortisol content o{ observation group was significantly higher than that of control group; serum nerve function indexes S10013, GFAP, Hcy and HO1 content were significantly higher than those of con- trol group while IGF-1 content was significantly lower than that of control group; humoral immunity indexes IgA, IgM, IgG, C3 and C4 content in serum were significantly lower than those of control group; cellular immunity indexes CD3＋ , CD4＋ and CD54＋T lymphocyte content in peripheral blood were significantly lower than those of control group while CD19＋ T lympho- cyte content and CD4＋/CD8＋ level were significantly higher than those of control group; hemodynamic indexes rCBF and rCBV levels were significantly lower than those of control group while MTT, TTP and DLY levels were significantly higher than those of control group. Serum cortisol level in cerebral infarction patients with infection was directly correlated with the levels of nerve function, humoral immunity, cellular immunity and other illness-related indexes. Conclusion： The high cortisol state in cerebral infarction patients with infection is the visual sign of severe nerve function damage and suppressed immune function, and it can be a reliable method for long-term treatment guidance and prognosis judgment.