大剂量丙种球蛋白对病毒性脑炎患者脑脊液中血清神经功能指标及相关炎症因子表达水平的影响

发布时间：2018-02-05 00:15

本文关键词： 丙种球蛋白病毒性脑炎神经功能指标炎症反应免疫功能　出处：《中华医院感染学杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的探讨大剂量丙种球蛋白对病毒性脑炎患者脑脊液中血清神经功能指标及相关炎症因子表达水平的影响。方法选择2012年3月-2016年6月在神经内科诊断治疗的病毒性脑炎患者120例,随机分为对照组和观察组,每组各60例;对照组静脉输注人血免疫球蛋白,400mg/kg·d,连续5d;观察组静脉输注人血免疫球蛋白,1 000mg/kg·d,连续2d;观察两组患者治疗前后血清神经元烯醇化酶(NSE)、S-100β蛋白、髓鞘碱性蛋白(MBP)、神经生长因子(NGF)的表达,治疗前后血清白细胞介素1(IL-1)、肿瘤细胞坏死因子α(TNF-α)、C-反应蛋白(CRP)的表达水平,治疗前后外周血清CD_3、CD_4、CD_8的表达。结果治疗后,两组患者血清NSE、S-100β、MBP、NGF表达与治疗前相比均下降,且观察组下降程度大于对照组,差异均有统计学意义(P0.05);治疗后,两组患者血清CRP、IL-1、TNF-α表达与治疗前相比均下降,且观察组下降程度大于对照组,差异均有统计学意义(P0.05);治疗后,两组患者血清CD_3、CD_4的表达较治疗前均显著升高,CD8的表达较治疗前显著降低,且观察组变化程度显著大于对照组,差异有统计学意义(P0.05)。结论大剂量应用丙种球蛋白可减少患者脑组织损伤,抑制炎症反应,维持机体免疫平衡,值得临床推广。
[Abstract]:Objective to investigate the effect of high dose gamma globulin on serum neurologic function and the expression level of related inflammatory factors in cerebrospinal fluid of patients with viral encephalitis. Methods from March 2012 to June 2016, the expression of related inflammatory factors was selected in the nerves of patients with viral encephalitis. 120 cases of viral encephalitis were diagnosed and treated. They were randomly divided into control group and observation group with 60 cases in each group. The control group received intravenous infusion of human immunoglobulin 400 mg / kg 路d for 5 days; In the observation group, human immunoglobulin was injected intravenously with 1 000 mg / kg / d for 2 days; The expression of serum neuron enolase (NSE) S-100 尾, myelin basic protein (MBP) and nerve growth factor (NGF) were observed before and after treatment. Before and after treatment, the levels of serum interleukin 1 (IL 1), tumor necrosis factor 伪 (TNF- 伪) and C- reactive protein (CRP) in serum and peripheral blood plasma CD_3 were observed before and after treatment. Results after treatment, the expression of NSES-100 尾 -MBPnF in serum of patients in both groups was lower than that before treatment, and the degree of decrease in the observation group was higher than that in the control group. The difference was statistically significant (P 0.05). After treatment, the expression of TNF- 伪 in serum of the two groups decreased compared with that before treatment, and the degree of decrease in the observation group was higher than that in the control group, and the difference was statistically significant (P 0.05). After treatment, the expression of CD3 + CD4 in serum of patients in both groups was significantly higher than that before treatment, and the expression of CD8 was significantly lower than that before treatment, and the degree of change in the observation group was significantly higher than that in the control group. Conclusion the application of high dose gamma globulin can reduce brain tissue injury, inhibit inflammatory reaction, maintain immune balance, and be worth popularizing in clinic.
【作者单位】：温州医科大学附属第一医院瓯北院区永嘉县中医医院神经内科;
【基金】：浙江省医药卫生一般研究计划基金资助项目(2014KYA194)
【分类号】：R512.3
【正文快照】： 病毒性脑炎是由各种可侵犯神经系统的病毒引起的脑实质以及脑膜的炎症[1],临床发现可引起本病的病毒约有100种以上,病毒性脑膜炎多见于小儿、青年,呈急性或亚急性发病,流行病学表现散发性或流行性[2-3]。我国病毒性脑炎发病率可达7/10万,常见病毒类型为单纯疱疹病毒、柯萨奇病

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