急性CO中毒后迟发性脑病患者脑脊液和血清可溶性白细胞介素-2受体水平

The changes of soluble interleukin-2 receptor in serum and cerebrospinal fluid of patients with delayed encephalopathy after acute carbon monoxide poisoning

目的 探讨急性一氧化碳中毒后迟发性脑病 (DEACMP)患者血清和脑脊液可溶性白细胞介素 2受体 (sIL 2R)的变化。方法 采用双抗体夹心ELISA法测定 31例DEACMP患者入院时、出院前的sIL 2R含量 ,并与 32例其他脑病组和 31例对照组作比较。结果 DEACMP组血清sIL 2R水平[(32 9.2 1± 16 0 .99)U/ml]明显高于对照组 [(115 .6 7± 89.5 8)U/ml],差异有显著性 (P <0 .0 5 ) ;与其他脑病组 [(36 7.5 0± 12 3.14 )U/ml]比较 ,差异无显著性 (P >0 .0 5 ) ;DEACMP组脑脊液sIL 2R水平[(5 4 .4 8± 4 3.0 4 )U/ml]略高于对照组 [(34.96± 2 2 .70 )U/ml],但明显低于其他脑病组 [(110 .2 4±76 .5 6 )U/ml],差异有显著性 (P <0 .0 5 )。DEACMP组血清sIL 2R水平入院时 [(338.34± 16 1.5 3)U/ml]与出院前 [(35 1.31± 175 .93)U/ml]比较 ,差异无显著性 (P >0 .0 5 ) ,而脑脊液sIL 2R水平出院前[(10 0 .2 6± 93.6 5 )U/ml]较入院时 [(5 2 .2 8± 4 3.31)U/ml]明显增高 ,差异有显著性 (P <0 .0 5 )。结论 本病的发生与免疫病理损伤有关 ,血清和脑脊液sIL 2R水平可以反映DEACMP患者机体的免疫状态 ,对判断病情程度及预后有一定的价值。

Objective To explore the changes of soluble interleukin-2 receptor(sIL-2R) in serum and cerebrospinal fluid(CSF) of patients with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP). Methods There were 31 patients with DEACMP,32 patients with other encephalopathy and 31 controls in this study.The levels of sIL-2R in serum and CSF were detected by ELISA. Results Serum sIL-2R in patients with DEACMP[(329.21±160.99)U/ml] was significantly higher than that in control[(115.67±89.58) U/ml,P<0.05)],but not significanly different from that in the other encephalopathy group[(367.50±123.14) U/ml,P>0.05)].CSF sIL-2R in patients with DEACMP[(54.48±43.04)U/ml] measured a little before discharge was significantly lower than that in patients with the other encephalopathy[(110.24±76.56)U/ml,P< 0.05)],but not significanly different from that in the control group[(34.96± 22.70)U/ml,P>0.05)].At the pre-discharged period,CSF sIL-2R in patients with DEACMP[(100.26±93.65)U/ml] was significantly higher than that at the early stage of hospitalization[(52.28±43.31)U/ml,P<0.05)].No significant difference in serum sIL-2R was found between early stage of hospitalization[(338.34±161.53)U/ml] and pre-discharge[(351.31±175.93)U/ml,P>0.05)]. Conclusion The occurrence of DEACMP may be related with immunopathological damage.The sIL-2R levels in serum and CSF may give information about the state of immunological function of the patients with DEACMP and may contribute to determining the patient's condition and prognosis.