神经梅毒患者外周血液淋巴细胞亚群及脑脊液指标分析

发布时间：2018-06-08 12:04

本文选题：神经梅毒 + 细胞免疫　；参考：《厦门大学》2014年硕士论文

【摘要】：梅毒是由梅毒螺旋体(Treponema pallidum, Tp)引起的严重危害人类健康的性传播性疾病。Tp可以在疾病的任何阶段入侵中枢神经系统,引起神经梅毒。由于神经梅毒临床症状复杂,误诊与漏诊率极高,早期诊断非常重要。目前,神经梅毒的诊断主要是依靠患者的病史、临床症状与体征、血液和脑脊液(CSF)的相关实验室检查。本课题分析了52例HIV阴性的神经梅毒患者外周血淋巴细胞亚群及CSF常规、生化、免疫实验室指标的变化,通过兔感染模型,分析经Tp感染后,新西兰兔CSF RPR、TPPA、常规及生化指标随感染时间不同的变化情况。探讨神经梅毒患者细胞免疫和体液免疫相关实验室指标对临床的应用价值。实验结果表明CD3+T淋巴细胞与CD3+CD4+T淋巴细胞在炎症反应最剧烈的早期神经梅毒患者体内含量最低,与无症状和晚期神经梅毒患者相比,早期神经梅毒患者的CD3+CD4+/CD3+CD8+比值差异最大,反映了早期神经梅毒患者体内存在明显的细胞免疫失衡。与正常对照组相比,神经梅毒患者的CD3+CD8+T淋巴细胞数量升高,NK细胞数量下降。CD3+CD8+T淋巴细胞和NK细胞在不同临床阶段神经梅毒患者及健康体检者间的含量变化均具有统计学差异。CSF白细胞(WBC)、CSF蛋白、CSF自蛋白、白蛋白商、CSFIgG、CSF IgA、IgG指数和IgA指数的升高,CSF乳酸脱氢酶(LDH)的降低都与神经梅毒的进展密切相关。与Nichols标准株相比,临床分离的野生株感染新西兰兔引起的免疫反应较弱。临床不同来源的Tp野生株感染新西兰兔,导致新西兰兔的CSF WBC、CSF蛋白、CSF白蛋白以及CSF LDH随病程的进展,含量升高到一定水平又逐渐下降,这与不同临床阶段神经梅毒患者CSF相应指标表现类似。血液和脑脊液的相关实验室检测对于神经梅毒的诊断和病情监测具有重要的作用。
[Abstract]:Syphilis is a sexually transmitted disease caused by Treponema pallium (TP), which can invade the central nervous system and cause neurosyphilis at any stage of the disease. Due to the complex clinical symptoms of neurosyphilis and high misdiagnosis and missed diagnosis, early diagnosis is very important. At present, the diagnosis of neurosyphilis mainly depends on the laboratory examination of the patient's history, clinical symptoms and signs, blood and cerebrospinal fluid (CSF). The changes of peripheral blood lymphocyte subsets and CSF routine, biochemical and immunological indexes in 52 HIV-negative neurosyphilis patients were analyzed. New Zealand rabbit CSF RPRP TPPA, routine and biochemical parameters varied with infection time. To investigate the clinical value of laboratory indexes related to cellular and humoral immunity in patients with neurosyphilis. The results showed that CD3 T lymphocytes and CD3 CD4 T lymphocytes were the lowest in patients with early neurosyphilis, who had the most acute inflammatory reaction, compared with asymptomatic and advanced neurosyphilis patients. The ratio of CD3 CD4 / CD 3 CD 8 in patients with early neurosyphilis was significantly different, which reflected the obvious imbalance of cellular immunity in patients with early neurosyphilis. Compared with the normal control group, Increased number of CD3 CD8 T lymphocytes in patients with neurosyphilis; decreased number of NK cells; changes of CD3 CD8 T lymphocytes and NK cells in patients with neurosyphilis at different clinical stages and healthy controls. CSF White blood cell (WBC) CSF protein and CSF self protein, The increase of IgG index and IgA index of CSF IgGG CSF and the decrease of LDHs of CSF lactate dehydrogenase are closely related to the progression of neurosyphilis. Compared with Nichols standard strain, the immune response of the isolated wild strain was weaker than that of the New Zealand rabbit. Wild strains of TP from different clinical sources were infected in New Zealand rabbits, which led to the increase of CSF WBC- CSF protein, CSF albumin and CSF LDH, which increased to a certain level and then decreased gradually with the progression of the course of the disease. This is similar to the corresponding CSF index in patients with neurosyphilis at different clinical stages. Laboratory tests of blood and cerebrospinal fluid play an important role in the diagnosis and monitoring of neurosyphilis.
【学位授予单位】：厦门大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R759.13

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