Department of Neurosurgery, Chubu Rosai Hospital, Nagoya, Japan.
J Clin Neurosci. 2010 Feb;17(2):187-90. doi: 10.1016/j.jocn.2009.04.020. Epub 2009 Dec 16.
The pathophysiology underlying the high incidence of post-stroke infectious complications has not been fully understood. We measured the respiratory burst of neutrophils as an index of their bactericidal function in patients with haemorrhagic stroke, and we also measured the plasma concentrations of noradrenalin, cortisol and neutrophil function-related amino acids. Blood samples were obtained from patients who underwent emergency craniotomies for haemorrhagic stroke (n=11) or CT-guided stereotaxic aspiration of intracerebral haematomas (n=6). Neutrophils were isolated, and their chemiluminescence response to N-formyl-methionyl-leucyl-phenylalanine was measured. Healthy volunteers served as controls (n=15). In patients with stroke, the chemiluminescence response of the isolated neutrophils was significantly lower than in the controls, and it was significantly inversely correlated with the plasma noradrenalin concentration. By Day 30, this value approached control levels. Other parameters measured were not significantly correlated with the chemiluminescence response. Stroke-induced suppression of the neutrophil respiratory burst may be responsible for frequent post-stroke infectious complications.
脑出血后感染并发症发生率高的病理生理学基础尚未完全阐明。我们测量了脑出血患者中性粒细胞的呼吸爆发（respiratory burst）作为其杀菌功能的指标，还测量了血浆中去甲肾上腺素、皮质醇和与中性粒细胞功能相关的氨基酸的浓度。从接受紧急开颅手术治疗脑出血的患者（n=11）或 CT 引导下立体定向抽吸脑内血肿的患者（n=6）中采集血液样本。分离中性粒细胞，并测量其对 N-甲酰基-甲硫氨酸-亮氨酸-苯丙氨酸的化学发光反应。健康志愿者作为对照组（n=15）。与对照组相比，中风患者分离的中性粒细胞的化学发光反应明显降低，且与血浆去甲肾上腺素浓度呈显著负相关。到第 30 天，该值接近对照水平。其他测量的参数与化学发光反应无显著相关性。中风引起的中性粒细胞呼吸爆发抑制可能是导致中风后频繁发生感染并发症的原因。
