慢性酒精中毒性脑病患者周围血T淋巴细胞亚群及C-反应蛋白水平变化研究

Study on the changes of peripheral blood T lymphocyte subpopulations and C-reactive protein levels in patients with chronic alcoholic encephalopathy

目的探讨慢性酒精中毒性脑病(CAE)患者周围血T淋巴细胞亚群及血清C-反应蛋白(CRP)水平与其病情严重程度的关系,并观察依达拉奉(EDA)+维生素联合治疗的临床效果。方法选取本院2013年2月-2015年2月收治的73例CAE患者,根据治疗前头颅磁共振成像(MRI)检查结果分为CAE组MRI正常组和CAE组MRI异常组,再按照治疗前脑电图(EEG)检查结果又分为CAE组EEG正常组和CAE组EEG异常组。并选取本院同期73例健康体检者为对照组。CAE患者,采取常规措施+EDA+维生素的联合方案治疗;对照组,不用任何药物。记录比较治疗前CAE患者和对照组的周围血T淋巴细胞亚群及血清CRP水平,治疗前CAE患者中CAE组MRI正常组和CAE组MRI异常组血清CRP水平,治疗前CAE患者中CAE组EEG正常组和CAE组EEG异常组血清CRP水平,CAE患者治疗前后周围血T淋巴细胞亚群及血清CRP水平;评价CAE患者用药安全性。结果与对照组相比,治疗前CAE患者CD3^+、CD4^+、CD8^+及CD4^+/CD8^+,均显著下降(P<0.01),且血清CRP水平显著升高(P<0.01)。治疗前CAE患者中CAE组MRI正常组血清CRP水平显著低于CAE组MRI异常组(P<0.01);与CAE组EEG异常组比较,治疗前CAE患者中CAE组EEG正常组血清CRP水平显著更低(P<0.01)。CAE患者治疗后T淋巴细胞亚群水平及血清CRP水平,均显著优于治疗前(P<0.01)。CAE患者用药期间不良反应率仅为5.5%。结论CAE患者机体存在免疫系统紊乱,通过监测其CRP水平可判断病情的严重程度,同时CAE患者应用EDA+维生素的联合方案治疗能显著改善机体免疫功能,降低CRP水平,且不良反应小,为临床诊治CAE提供了新方向。

Objective To investigate the relationship of peripheral blood T lymphocyte subpopulations and serum C-reactive protein （ CRP ） level with the severity of the disease on patients with chronic alcoholic encephalopathy （ CAE ） and to observe the clinical effect of edaravone （ EDA ） combined with vitamin. Method 73 cases of CAE patients in our hospital from February 2013 to February 2015 were selected and divided into MRI normal group and MRI abnormal group according to the test results before the cranial magnetic resonance imaging （ MRI ） examination of CAE group and then divided into EEG normal group and EEG abnormal group according to the treatment of electroencephalogram （ EEG ） examination results of CAE group. And 73 cases of healthy physical examination in our hospital were selected as the control group. CAE patients adopted the combination of conventional measures, vitamin and EDA; the control group was without any drugs. The peripheral blood T lymphocyte subpopulations and serum CRP level of the CAE patients before the treatment and control group, MRI normal group and MRI abnormal serum CRP level in the CAE group before the treatment, serum levels of CRP of the EEG normal group and abnormal EEG group in the CAE group before the treatment, peripheral blood T lymphocyte subpopulations and serum CRP level of the CAE group after the treatment were recorded and compared; the drug safety in the CAE patients was evaluated. Results Compared with those of the control group, CD3^＋, CD4^＋, CD8^＋ and CD4^＋/CD8^＋ in the CAE patients before the treatment significantly decreased （ P〈0.01 ） , and the level of serum CRP significantly increased （ P〈0.01 ） . Before the treatment, the serum CRP level of MRI in the normal group was significantly lower than that of the MRI group in the CAE group （ P〈0.01 ） ; compared with that of the EEG abnormal group, the serum CRP level of the EEG group was significantly lower before the treatment in the CAE group （ P〈0.01 ） . The level of T lymphocyte subsets and serum CRP levels in the group CAE were both significantly better than that before the treatment （ P〈0.01 ） . The adverse reaction rate was only 5.5% in the CAE patients. Conclusion Immune system disorder exists in CAE patients, the severity of the CRP level can be monitored by the CRP level and the combination of vitamin and EDA treatment can significantly improve the immune function, decrease the level of CRP on CAE patients, and the side effect is small, providing a new direction for clinical diagnosis and treatment of CAE.