摘要
目的分析神经内科医院感染患者免疫炎症指标和预后,为临床用药提供参考依据。方法选取2015年1月至2015年12月收治后确诊为医院感染患者60例为观察组,未发生医院感染患者80例为对照组。检测2组神经功能指标[S100β蛋白(S100β)、胶质纤维酸性蛋白(GFAP)、同型半胱氨酸(Hcy)、脑源性神经营养因子(BDNF)、胰岛素样生长因子-1(IGF-1)]、脑血流学指标(基底动脉、左大脑中动脉、右大脑中动脉血流)、应激指标[皮质醇(Cor)、去甲肾上腺素(NE)、肾上腺素(AD)、肾上腺皮质激素(ACTH)]、炎性指标[白细胞计数(WBC)、中性粒细胞计数(NEUT)、淋巴细胞计数(LY)、C-反应蛋白(CRP)、降钙素原(PCT)]、细胞因子[白介素6(IL-6)、白介素8(IL-8)、白介素10(IL-10)、肿瘤坏死因子α(TNF-α)]、细胞免疫指标[T淋巴细胞亚群(CD^+3、CD^+4、CD^+8、NK细胞)、NK细胞]、体液免疫指标[免疫球蛋白(IgA、IgG、IgM)、补体C3、C4]和预后。结果观察组S100β、GFAP、Hcy、Cor、NE、AD、ACTH、WBC、NEUT、LY、CRP、PCT、IL-6、IL-8、IL-10、TNF-ɑ、CD^+8、mRS评分较对照组明显升高(P<0.05),BDNF、IGF-1、基底动脉、左大脑中动脉、右大脑中动脉血流、CD^+3、CD^+4、CD^+4/CD^+8、NK、IgA、IgG、IgM、C3、C4、ADL评分较对照组明显降低,差异有统计学意义(P<0.05)。结论神经内科医院感染患者神经功能、脑血流学指标、细胞因子分泌异常,且细胞免疫和体液免疫受到抑制,这是导致感染发生、进展及预后不良关键环节。
Objective To investigate the inflammatory and immune-related indexes and prognosis of patients with nosocomial infection in department of neurology,so as to provide evidence for clinical medication.Methods A total of 60 patients who hospitalized in department of neurology from January 2015 to December 2015 who were admitted and diagnosed as nosocomial infection were enrolled as observation group,and the other 80 inpatients without nosocomial infection were enrolled as control group.The nerve function indexes(S100β,GFAP,Hcy,BDNF and IGF-1),the cerebral blood flow indexes(basilar artery,left middle cerebral artery and right middle cerebral artery blood flow),stress hormones(Cor,NE,AD and ACTH),inflammatory indicators(WBC,NEUT,LY,CRP and PCT),cytokines(IL-6,IL-8,IL-10 and TNF-α),cellular immunity indicators(CD^+3,CD^+4,CD^+8 and NK),humoral immunity indicators(IgA,IgG,IgM,C3 and C4])and prognosis of patients were observed and compared between the two groups.Results The levels of S100β,GFAP,Hcy,Cor,NE,AD,ACTH,WBC,NEUT,LY,CRP,PCT,IL-6,IL-8,IL-10,TNF-α,CD^+8 and mRS scores in observation group were higher than those in control group(P<0.05),however,the levels of BDNF,IGF-1,blood flow of basilar artery,left middle cerebral artery and right middle cerebral artery,CD^+3,CD^+4,CD^+4/CD^+8,NK,IgA,IgG,IgM,C3,C4 and ADL scores in observation group were significantly lower than those in control group(P<0.05).Conclusion The abnormalities of nerve function,cerebral blood stream indexes and cytokine secretion exist in patients with nosocomial infection in department of neurology,moreover,whose cellular immunityand humoral immunity are suppressed,which are correlated with the incidence of nosocomial infection,development and poor pgognosis of patients.
作者
段海丽
吕学海
刘运平
叶秋桠
陈鹏杰
DUAN Haili;LV Xuehai;LIU Yunping(Department of Rehabilitation Medicine,Central Hospital of Handan City,Hebei,Handan 056000,China)
出处
《河北医药》
CAS
2020年第24期3782-3785,共4页
Hebei Medical Journal
基金
河北省卫生与计划生育委员会科研基金项目(编号:20150455)。
关键词
神经内科住院患者
医院感染
免疫炎症指标
预后
hospitalized patient in department of neurology
nosocomial infection
inflammatory and immune-related indexes
prognosis
