摘要
目的 观测卒中患者外周血T细胞亚型的改变,探讨卒中后感染发生的危险因素.方法取卒中患者(n=37)入院时、入院后第1、7和14天以及对照组(同期体检的健康患者20例)的外周血,流式细胞仪检测外周血CD3+、CD4+、CD8+及CD4+/CD8+变化,将符合标准的卒中患者纳入感染组和未感染组,Logistic回归分析卒中后发生感染的易感因素.结果 卒中患者CD3+、CD4+和CD8+T细胞百分比较对照组明显下降,差异均有统计学意义(P<0.05).在卒中后出现感染的患者(n=12),在入院后的第1、7、14天外周血CD3+、CD4+和CD8+T细胞百分比逐步上升,但在整个观察期内仍明显低于对照组,差异均有统计学意义(P<0.05);卒中后未发生感染的患者(n=12),CD4+T细胞百分比在入院后第1天起与对照组比较,差异均无统计学意义(P>0.05).Logistic回归分析结果显示卒中入院时CD4+、CD8+T细胞百分比,入院第1天CD3+、CD4+T细胞百分比,入院第7天CD3+、CD4+、CD8+T细胞百分比以及入院第14天CD3+T细胞百分比与卒中后发生感染密切相关.结论 卒中患者存在外周血T细胞亚型的变化和免疫功能的降低,T细胞亚型的变化可能对卒中后感染的发生有一定的影响.
Objective To study the changes of T lymphocyte subsets in the peripheral blood of patients with stroke to explore the risk factors of post-stroke infection. Methods A total of 37 patients with stroke and 20 age-matched controls were included in the study and blood was obtained from the controls and patients immediately at the admission and 1, 7 and 14 d after the admission. Fluorescein isothiocyanate was used to label the leukocyte subsets (CD3, CD4, CD8); the changes of CD3+, CD4+,CD8+ and CD4+/CD8+ were detected by flow cytometry. Patients met the infection standards were divided into infection group (n=12) and non-infection group (n=12); and logistic regression analysis was performed to determine the risk factors of post-stroke infection, accordingly. Results Stroke induced a dramatic and immediate loss of T-lymphocytes, mostly pronounced with the percentages of CD3+, CD4+and CD8+ T cells (P〈0.05). The percentages of CD3+, CD4+ and CD8+ T cells of infected patients were gradually increased on 1, 7 and 14 d after the admission; compared with those of controls, their percentages were still significantly lower throughout the observation period (P〈0.05). No significant differences on the percentage of CD4+ T cells were noted between the non-infected patients and the controls since the 1st admission day (P〉0.05). Logistic multivariate analysis indicated that the percentages of CD4+ and CD8+ T cells on admission, CD3+ and CD4+ T cells on the 1st d of admission, CD3+, CD4+and CD8+ T cells on the 7th d of admission, CD3+ T cells on the 14th d of admission were closely related to the post-stroke infection. Conclusion Stroke induces significant changes of T lymphocyte subsets in the peripheral blood and immunosuppression in humans; the alteration of T lymphocyte subsets may influence the development of post- stroke infection.
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2010年第9期944-947,共4页
Chinese Journal of Neuromedicine