重型脑外伤患者T细胞亚群与免疫球蛋白的变化及意义

Severe craniocerebral trauma patients T-lymphocyte subpopulation′s and immunoglobulin′s change and clinical meanings

目的探讨重型颅脑外伤患者T淋巴细胞亚群与血清免疫球蛋白的变化及其临床意义。方法对42例重型颅脑外伤 (GCS≤8分 )患者外周血T淋巴细胞亚群及其血清免疫球蛋白进行检测 ,并与对照组 (37例门诊健康体检者 )进行比较。结果脑外伤患者CD3 +、CD4+、CD4+/CD8+比值均显著下降 (P<0.01) ;CD8+明显升高 (P<0.01) ,IgG、IgM也明显低于对照组 (P<0.01) ,脑外伤感染组CD4 +、CD4 +/CD8 +比值及IgG、IgM显著低于未感染组 (P<0.01)。结论重型颅脑外伤患者机体免疫功能处于严重抑制状态 ,其不仅有细胞免疫功能降低 ,也存在体液免疫功能降低。机体的整体免疫功能降低 ,是伤后继发感染的主要原因。早期检测外周血T淋巴细胞亚群与血清免疫球蛋白 ,并对有严重免疫功能抑制的患者早期使用适当抗生素及适量的免疫调节药物 ,预防感染 。

Objective To study T_lymphocyte subpopulation′s and immunoglobulin′s change and clinical meanings of severe craniocerebral trauma patients. Methods The peripheral blood T_lymphocyte subpopulation and its serum immunoglobulin of 42 cases severe craniocerebral trauma patients were tested. And the acquired data was compared with the control group (37 cases health_check people in outpatient service). Results The ratio of CD3+?CD4+? CD4+/CD8+ of craniocerebral trauma patients declines distinctively (P<0.01), but the CD8+ elevates distinctively (P<0.01). The IgG and IgM were also lower than the control group (P<0.01). The ratio of CD4+?CD4+/CD8+, of the infected craniocerebral trauma group was lower than the uninfected group (P <0.01). Conclusion The immunological conditions of severe craniocerebral trauma patients are highly inhibited both the cellular and humoral immunological function is declined. The fall of the whole body′s immunological function becomes the main reason of the secondary infection after trauma. So the early test of peripheral blood T_lymphocyte subpopulation and serum immunogobulin and applying suitable antibrotic and immunoregulatory drugs to the patients whose immunological function has been highly inhibited to prevent from infection have important clinical meanings.