Correlation between CD8+CD28- Treg and intracranial pressure in craniotomy patients with craniocerebral injury
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摘要:
目的 探讨颅脑损伤开颅手术患者颅内压变化与CD8+CD28-调节性T细胞(Treg)的关系。 方法 以56例颅脑损伤开颅手术患者作为观察组(A组),以38例急性大面积脑梗死进行开颅去骨瓣减压的患者作为阳性对照(B组),并以40例健康志愿者作为阴性对照(C组);比较以上3组外周血及脑脊液内CD8+CD28-Treg及其细胞因子白介素10(IL-10)及转化生长因子β1(TGF-β1)的百分含量,并监测A组在不同时间点颅内压、CD8+CD28-Treg、IL-10及TGF-β1的变化,并分析其相关性。 结果 A组术前CD8+CD28-Treg、IL-10及TGF-β1均不同程度低于B及C组(P<0.05),但B组与C组差异无统计学意义(P>0.05)。随着病情的推演,A组患者颅内压逐渐降至正常,而外周血及脑脊液内CD8+CD28-Treg、IL-10及TGF-β1均逐渐回升。相关性分析显示颅内压与CD8+CD28-Treg、IL-10及TGF-β1均呈显著负相关。 结论 CD8+CD28-Treg及其细胞因子降低是颅脑损伤的重要免疫学现象,且与颅内压升高存在密切关系。 -
关键词:
- 颅脑损伤 /
- 颅内压 /
- CD8+CD28-调节性T细胞 /
- 细胞因子
Abstract:Objective To explore the correlation between CD8+CD28-Treg and intracranial pressure in craniotomy patients with craniocerebral injury. Methods Fifty-six patients with craniocerebral injury surgical operation were chosed as observation group (group A), 38 cases with acute massive cerebral infarction who underwent decompressive craniectomy were chosed as the positive control (group B), and 40 healthy volunteers were chosed as the negative control group (group C). CD8+CD28-Treg, cytokine interleukin 10 (IL-10) and transforming growth factor beta 1 (TGF-beta 1) percentage in peripheral blood and cerebrospinal fluid were compared. Intracranial pressure, CD8+CD28-Treg, IL-10 and the TGF-beta 1 of Group A in different time were compared, with correlation analyzed. Results Preoperative CD8+CD28-Treg, IL-10 and TGF-beta 1 of group A were lower than that of group B and C (P<0.05), but no significant difference was found between B and C (P>0.05). With the deduction of the illness, intracranial pressure of group A droped to normal level gradually, and CD8+CD28-Treg, IL-10 and TGF-beta 1 in peripheral blood and cerebrospinal fluid were gradually recovered.Correlation analysis showed that intracranial pressure had a negative correlation with CD8+CD28-Treg, IL-10 and TGF-beta 1. Conclusion CD8+CD28-Treg cells and its cytokine reduction are important phenomenon of immunology in craniocerebral injury. There is a close relationship with elevated intracranial pressure. -
Key words:
- craniocerebral injury /
- intracranial pressure /
- CD8+CD28-regulatory T cells /
- cytokines
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表 1 3组研究对象外周血CD8+CD28-Treg及其细胞因子含量比较(%,
$\, \overline{{x}}{{±}}{{s}}$ )分组 n CD8+CD28-Treg IL-10 TGF-β1 A组 56 4.13±0.95*# 3.02±0.81*# 1.16±0.32*# B组 52 10.91±3.88 8.16±2.58 5.87±3.27# C组 55 12.42±4.17 9.37±3.09 7.13±2.64* F -4.182 -3.221 -5.193 P 0.003 0.016 0.000 *P<0.05vs B组; #P<0.05vs C组. 表 2 开颅患者不同时间点CD8+CD28-Treg的百分含量变化(
$\, \overline{{x}}{{±}}{{s}}$ )分组 n 术后24 h 术后第4天 术后第7天 外周血 脑脊液 外周血 脑脊液 外周血 脑脊液 A组 56 4.01±1.03 0.92±0.26 6.39±2.35 1.69±0.52 11.32±2.73 2.78±0.89 B组 52 8.92±3.37 1.96±0.43 10.23±4.62 2.53±0.68 12.45±4.12 3.04±1.76 t -3.202 -2.183 -2.831 -1.922 -0.814 -1.025 P 0.006 0.013 0.017 0.037 0.089 0.103 表 3 开颅患者不同时间点IL-10的百分含量(
$\, \overline{{x}}{{±}}{{s}}$ )分组 n 术后24 h 术后第4天 术后第7天 外周血 脑脊液 外周血 脑脊液 外周血 脑脊液 A组 56 3.15±0.78 0.79±0.21 5.28±2.17 1.27±0.43 9.13±2.24 2.51±0.71 B组 52 7.04±2.61 1.61±0.39 8.36±3.85 2.23±0.56 10.21±3.98 2.83±1.53 t -3.013 -2.461 -2.712 -1.724 -0.922 -0.913 P 0.009 0.018 0.023 0.041 0.073 0.142 表 4 开颅患者不同时间点TGF-β1的百分含量(
$\, \overline{{x}}{{±}}{{s}}$ )分组 n 术后24 h 术后第4天 术后第7天 外周血 脑脊液 外周血 脑脊液 外周血 脑脊液 A组 56 1.03±0.21 0.36±0.11 3.27±1.02 0.88±0.27 5.19±1.78 1.13±0.32 B组 52 3.29±0.72 0.72±0.21 6.13±3.04 1.52±0.39 6.36±2.87 1.76±0.59 t -2.894 -1.929 -2.251 -1.503 -0.871 -0.802 P 0.011 0.032 0.039 0.047 0.083 0.163 表 5 两组患者颅内压比较(
$\, \overline{{x}}{{±}}{{s}}$ ,mmHg)分组 n 术后24 h 术后第4天 术后第7天 A组 56 91.29±26.37 69.39±18.19 53.27±12.45 B组 52 88.38±22.52 62.17±15.22 50.16±11.38 t 3.923 5.923 2.012 P 0.078 0.025 0.096 表 6 A组患者脑脊液内CD8+CD28-Treg及其细胞因子与临床指标的相关性(
$\, \overline{{x}}{{±}}{{s}}$ )指标 CD8+CD28-Treg IL-10 TGF-β1 r P r P r P 颅内压 -0.728 0.003 -0.713 0.008 -0.684 0.013 GCS 0.684 0.011 0.651 0.015 0.632 0.021 NIHSS -0.762 0.000 -0.743 0.001 -0.715 0.006 GCS:格拉斯哥昏迷评分;NIHSS:美国国立卫生研究院卒中量表. -
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