Epifantseva N N, Borshchikova T I, Surzhikova G S, Churliaev Iu A, Dantsinger D G, Vialova V N, Purakhina S M
Anesteziol Reanimatol. 2009 Nov-Dec(6):65-8.
Fifty-three patients aged 17-65 years who had severe brain injury (SBI) were examined and randomized to 2 groups: 1) 16 patients without complications; 2) 37 patients developed pneumonia (35.2%), bronchitis (32.4%), meningitis (10.8%), meningitis concurrent with pneumonia (8.1%), bedsores concurrent with bronchitis (13.5%) on days 4-7. The authors studied the immune status: the subpopulation composition of lymphocytes (CD+, a marker of adult lymphocytes; CD+, a marker of T helper/inductor cells, CD8+, a marker of cytotoxic lymphocytes, CD16+, a marker of natural killer cells, CD20+, a marker of B lymphocytes) by the indirect immunofluorescence technique using monoclonal antibodies; the functional activity of lymphocytes from the expression of activation antigens, such as CD71+, CD25+, HLA-DR; serum immunoglobulins (IgG, IgA, and IgM) by the immunoturbidimetric technique using the test systems (Spinreakt, Spain). A control group included 23 apparently healthy individuals. Immunosuppression developing as significant T lymphopenia due to lower CD4+ and CD8+ lymphocytes, as well as impaired humoral immunity with inadequate IgG generation was detected in the acute phase of SBI. The indicators reflecting the development of secondary pyoseptic complications were elevated CD3+, CD4+, and CD8+ lymphocytes on day 7 and the higher lymphocytic expression of the activation antigens CD25+ and CD71+. The findings show that the diagnostic markers, such as CD3+, CD4+, CD8+, CD25+, and CD71+ lymphocytes, should be included into a comprehensive examination of patients with SBI.
对53例年龄在17至65岁之间的重度脑损伤（SBI）患者进行了检查，并将其随机分为两组：1）16例无并发症患者；2）37例在第4至7天出现肺炎（35.2%）、支气管炎（32.4%）、脑膜炎（10.8%）、肺炎并发脑膜炎（8.1%）、支气管炎并发褥疮（13.5%）的患者。作者研究了免疫状态：采用单克隆抗体通过间接免疫荧光技术检测淋巴细胞亚群组成（CD+，成人淋巴细胞标志物；CD+，辅助性T/诱导性T细胞标志物，CD8+，细胞毒性淋巴细胞标志物，CD16+，自然杀伤细胞标志物，CD20+，B淋巴细胞标志物）；通过激活抗原如CD71+、CD25+、HLA-DR的表达检测淋巴细胞的功能活性；采用免疫比浊技术使用检测系统（西班牙Spinreakt）检测血清免疫球蛋白（IgG、IgA和IgM）。对照组包括23名明显健康的个体。在SBI急性期检测到由于CD4+和CD8+淋巴细胞减少导致显著的T淋巴细胞减少而出现的免疫抑制，以及体液免疫受损伴IgG生成不足。反映继发性化脓性并发症发生的指标是第7天CD3+、CD4+和CD8+淋巴细胞升高以及激活抗原CD25+和CD71+的淋巴细胞表达更高。研究结果表明，CD3+、CD4+、CD8+、CD25+和CD71+淋巴细胞等诊断标志物应纳入SBI患者的综合检查中。
