老年脑梗死患者红细胞免疫功能动态观察

Dynamic observation of immunological function of erythrocyte in the elderly patients with cerebral infarction

目的 研究老年脑梗死患者各期红细胞免疫功能状况的动态变化。探讨红细胞免疫系统与老年脑梗死发生发展的关系。 方法 采用红细胞酵母菌SPA混合花环试验测CR1活性及红细胞粘附免疫复合物的量及血清中红细胞免疫调节因子 (RAIF)的变化 ,间接免疫SPA法测定人外周血T淋巴细胞亚群 ,聚乙二醇沉淀法检测血清循环免疫复合物 (CIC)水平 ,单向免疫扩散法测血清C3含量。 结果 ( 1)老年脑梗死患者存在红细胞C3b受体活性低下 (P <0 0 1) ,其表面免疫复合物明显增多 (P <0 0 1) ,尤以急性期显著 ,RAIF升高 ,以急性期显著 ;( 2 )在急性期、亚急性期、恢复期T细胞亚群CD4百分比降低 (P <0 0 5 ) ,而CD8百分比升高 (P <0 0 5 ) ,CD4/CD8比值明显降低 ,同时C3含量明显降低 (P <0 0 1) ,血清CIC明显增高 (P <0 0 1) ,以上各指标均随脑梗死病情的恢复而趋于正常 ;( 3)老年脑梗死的发病过程中 ,红细胞C3b受体花环率的变化与红细胞免疫粘附促进因子 (RAEF)、C3含量、CD4百分比呈正相关 ,而与RAIF、红细胞免疫复合物花环率 (RRSF)、CIC、CD8百分比呈负相关 ,与CD3百分比无关 ,CD4百分比的变化与RAIF呈明显的负相关 ,与RAEF正相关 ;而CD8的变化与RAIF正相关 ,与RAEF负相关。

Objective To study the dynamic changes of the immunological function of erythrocyte during different stages of senile cerebral infarction,and explore the relationship between the erythrocytic immunological system and the pathogenesis and development of senile cerebral infarction Methods Erythrocytic yeast-SPA mixed rosette for CIA,indirect SPA assay for T cell subsets,polyglycol sendimentation assay for serum CIC level and one-way immunodiffusion for serum C3 content were applied. Results (1)RBC immune system takes part in the pathogenesis of cerebral infarction.Decreasing of the RBC immune adherence function in patients with cerebral infarction is one of the important causes of decreasing of C3 and CIC in serum and disorder of T cell subsets.(2)CIC is not deposited on the surface of RBC simply,and RBC does play active role in immune adherence to CIC.(3)RAIF and RAEF are main factors that regulated RBC immune adherence function.In addition,variation of CIC and C3 in serum also affects activity of RBC-C3 receptor. Conclusions There is a close correlation between RBC immune system and bodys immune systm.RBC immune system can play an important role in evaluating the severity,prognosis and instructing the therapy.