高血压脑出血患者血清免疫球蛋白和补体C3、C4变化的临床意义

Observationthe of the change of hypertension cerebral hemorrhage patients serum immunoglobulin and the change of complement of C3 and C4,and the exploration of its clinical significance

目的:观察高血压脑出血患者血清免疫球蛋白(Ig G、Ig A、Ig M)和补体C3、C4的变化,探讨其临床意义。方法:选取40例高血压脑出血患者,根据GCS评分选取(12-3分)中重度患者40人,分别于入院第1、3、5、7、9、11 d抽取外周血检测免疫球蛋白和补体C3、C4,分析总体动态演变,探讨其临床意义。结果:高血压脑出血中重度患者中,Ig G除第1天无统计学意义,其余各时间段均有意义(P <0. 01);Ig A除第1、11天无统计学意义,其余均有统计学意义(P <0. 01);Ig M除第1、3、11天无统计学意义,其余均有统计学意义(P <0. 01);C3除第11天无统计学意义,其余均有统计学意义(P <0. 01);C4除第9、11天无统计学意义,其余均有统计学意义,预后不良者与预后良好者免疫球蛋白及C3、C4比较显示预后不良者较预后良好者免疫球蛋白下降时间提前,恢复缓慢,C3、C4较良好组提前过度激活(P <0. 01)。结论:免疫球蛋白及补体C3、C4可以间接反应高血压脑出血患者预后情况,早期检测血清免疫球蛋白及补体,适当使用免疫调节药物,减少并发症的发生,改善患者预后。

Objective:Observation of the change of hypertension cerebral hemorrhage patients serum immunoglobulin(IgG,IgA,IgM)and the change of complement of C3and C4,and the exploration of its clinical significance.Methods:Selecting40patients with hypertensive cerebral hemorrhage according to GCS score(12-3points)in patients with40people that were moderately severe,respectively,put into the hospital on1st,3ed,5th,7th,9th,11th days peripheral blood immunoglobulin and complement C3and C4,which were analysised about dynamic evolution,and exploring its clinical significance.Results:Hypertensive cerebral hemorrhage in severe patients,IgG was not significant except for1st day,and the rest of the time was significant(P<0.01);IgA except1st,11days without statistical significance,and the others all had statistical significance(P<0.01);IgM in addition to the1st,3ed,11thdays without statistical significance,and the others all had statistical significance(P<0.01);C3in addition to the11th day was of no statistical significance,and the others all had statistical significance(P<0.01);C4except9and11th days without statistical significance,and the rest all had statistical significance.Poor prognosis of patients with immunoglobulin declined ahead of time and restored slower by comparison of good prognosis of patients.C3and C4were excessively activated in advance in the good prognosis group(P<0.01).Conclusion:Immunoglobulin and complement C3and C4can indirectly react the prognosis in patients with hypertensive cerebral hemorrhage.Early immunomodulatory drugs to patients'disease are positive,and have important clinical significance in the whole process of treatment and prognosis.