缺血性脑卒中诱导的免疫抑制综合征与副交感神经系统的相关性

Ischemic stroke induced immunodeficiency syndrome and Parasympathetic nervous system

卒中后感染是卒中患者最常见的并发症之一,其高发的原因是中枢神经系统损伤诱导的免疫抑制综合征。本综述阐述了两个独立的现象。(1)在脑梗死细胞水肿高峰期,及脑梗死数周后存在免疫抑制,可能与交感与副交感神经同时受抑制、副交感神经系统相对增强有关;(2)副交感神经活化对非特异性免疫具有明显的抑制作用,因而可以抑制特异性免疫。据此我们推测脑梗死后高发的感染率及免疫反应受损,至少在某种程度上与迷走神经活性的增加及继发的免疫抑制相关。

Post-stroke infection is the most common complication in patients with stroke, the cause of the high incidence is due to central nervous system injury-induced immunodepression syndrome. This review describes two separate phenomena. （ 1 ） In the peak of cerebral cell swelling, and a few weeks after stroke, immunodepression may be related to simultaneous suppressing to sympathetic and parasympathetic nervous system and the relative increase of parasympathetic nervous system activition. （2） The parasympathetic activation has obvious inhibitory effect on non-specific immunity, which can inhibit the specific immune response. Accordingly, we speculated that high rates of infection after cerebral infarction and impaired immune response, are at least to some extent related with the increase of vagus nerve activity and secondary immunodepression.