一氧化氮在皮肌型和脑型囊尾蚴病患者免疫机制中的意义

Significance of Measurement of Nitric Oxide in Immunological Mechanism in Patients with Cutaneous-muscular and Cerebral Cysticercosis

目的测定并比较皮肌型和脑型囊尾蚴病患者血清和脑脊液中特异性IgG和一氧化氮(N0)含量,以分析NO在不同类型的囊尾蚴患者免疫反应中的意义。方法分别检测皮肌型囊尾蚴病患者(40例)血清、脑型囊尾蚴病患者(42例)血清和脑脊液中特异性IgG的含量和NO的水平,并分别记录两组患者的皮肤结节的数量和颅内压的水平,以结节数量分为少结节组(结节<15个)和多结节组(结节≥15个):根据压力的数值分为颅内高压组(压力≥180mmH2O组,1mmHg=0·133kPa)和正常颅内压组(压力<180mmH2O组)。另外检测23例大隐静脉曲张患者(对照组)血清和脑脊液中NO水平。结果皮肌型囊尾蚴病患者血清中特异性IgG含量和NO水平明显高于对照组(P<0.01):脑型囊尾蚴病患者的血清、脑脊液中特异性IgG含量和NO均明显高于对照组(P<0.01)。皮肌型囊尾蚴病患者血清中NO水平和特异性IgG呈正相关;脑型囊尾蚴病组患者脑脊液中NO水平与特异性IgG含量呈显著正相关。高颅内压患者脑脊液中NO水平高于无高颅内压的患者(均P<0.05)。多结节组患者血清中NO水平与少结节组相比明显升高(P<0.05)。结论NO在皮下肌肉组织和中枢神经系统均参与了囊尾蚴病急性期机体的抗囊虫免疫反应,并与临床症状的轻重有关。

Objective To evaluate the significant of nitric oxide （NO） in immunoreaction in two different kinds of cysticercosis patients, and to measure NO concentration and IgG level in the patients with cutaneous-muscular and cerebral cysticercosis. Methods The intracranial pressure and the tubercle numbers were observed in 40 cases of cutaneous-muscular cysticercosis and in 42 cases of neurocysticercosis （cerebral） cysticercosis respectively, and the NO concentration and the IgG level of serum and cerebrospinal fluid （CSF） were measured. The cutaneous-muscular cysticercosis patients were allotted to two groups by the number of tubercles, i.e. less-tubercle group （ the number of tubercles 〈 15 ） and more-tubercle group （ ≥15 ）. The cerebral cysticercosis patients were allotted to two groups by the values of intracranial pressure, i.e. normal pressure group （ 〈 180 mmHO2 ） and intracranial hypertension group （≥180 mmHO2 ）. Another 23 patients with varicosis of great saphenous vein were selected to form control group. Results The No concentration and the IgG level in serum of cutaneous-muscular cysticercosis patients and those in serum and CSF of cerebral cysticercosis patients significantly increased as compared with that of the control group. There was a positive correlation between NO concentration and IgG level in the serum of cutaneous - muscular eysticercosis patients or in the CSF of cerebral cysticercosis patients. The NO concentration in the CSF in the neurocysticercosis patients with intracranial hypertension was clearly higher than that of those without intracranial hypertension （ P 〈 0.05 ）. As compared with less-tubercle group, the NO level in the serum of more-tubercle group increased significantly （P 〈 0.05）. Conclusion NO plays an important role in the acute immune response to cysticercosis, in which cutaneous-muscular tissue and cerebral nerve system are involved. The severity of clinical manifestation may be correlative to NO concentration.