老年人急性脑血管病免疫功能变化及其临床意义

Variation of Immunogical Function and Its Clinical Significance in Old Patients with Acute Cerebrovascular Disease

目的 了解老年人急性脑血管病免疫功能的变化及临床意义。方法 检测１２８ 例患者外周血Ｔ淋巴细胞亚群和免疫球蛋白水平，并观察急性期与恢复期的动态变化。结果 脑梗死组和脑出血组外周血Ｔ细胞亚群有异常变化，ＣＤ４ 水平较正常对照组升高（Ｐ＜ ０．０５），其中脑梗死组升高更明显，６０～６９ 岁组与７０ 岁及７０ 岁以上组比较无差异，而ＣＤ８ 在脑梗死７０ 岁及以上组较６０～６９ 岁组明显下降（Ｐ＜ ０．０５）；脑出血组与脑梗死组之间外周血Ｔ淋巴细胞亚群水平的差异比较无显著意义。ＩｇＧ、ＩｇＭ 水平在两组患者中均有明显下降，与正常对照组有显著或非常显著性差异（Ｐ＜０．０５ 或Ｐ＜ ０．０１），在脑出血组下降更明显，恢复期有明显改善。结论 老年人急性脑血管病患者存在免疫功能的改变，脑梗死患者以Ｔ细胞亚群改变较明显，而脑出血患者则以免疫球蛋白改变更明显，早期预防动脉粥样硬化。

Objective The purpose of this study was to clarify the variation of immunogical function of old patients with acute cereborvascular disease and its clinical significance.Method The levels of peripheral blood subgroup of T lymphocyte and immunoglobulin in 128 patients were investigated and their variation in acute and recovering stage of disease. Results The level of CD4 was high as compared with normal controls (P<0.05), and that of brain infarction was even higher, but that in 60 69 years group and over 70 years group were indifferent. The levels of CD8 in 70 years old patients of brain infarction were lower as compared with that of 60 69 years old patients. No significant difference was found in the levels of peripheral blood subgroup of T lymphocyte between patients of brain infarcion and cerebral hemorrhage. The levels of IgG、IgM were decreased evidently in two group patients as compared with normal controls (P<0.05 and P<0.01 ), and it was more evident in cerebral hemorrhage group, but it was improved during the recovery stage. Conclusion There were alterations of immunogical function in old patient with acute cerebrovascular disease. To prevent arteriosclerosis and improve immunologic function is helpful in prevention and treatment of cerebrorascular disease.