摘要
目的 探讨T淋巴细胞亚群及性激素变化在脑损伤中的作用。 方法 对 10 1例急性颅脑损伤患者血中CD4 + 、CD8+ T淋巴细胞及血清和脑脊液中雌二醇、孕酮和睾酮分别在伤后<12h、1,3,7d进行动态观察及相关分析。 结果 伤后各组CD4 + 、CD8+ T淋巴细胞均受抑制 ,并随损伤程度而加重 ;各组伤后 12h内血清、脑脊液内雌二醇和孕酮升高 ,而格拉斯哥昏迷评分 (GCS)≤ 8分组雌二醇伤后 1d和 3d、孕酮 7d内持续增高 ,与其他各组比较差异有显著性意义或非常显著性意义 (P <0 .0 5 ,0 .0 1) ;死亡组血清、脑脊液内睾酮降低 ,GCS≤ 8分组脑脊液内睾酮升高 ;死亡组中CD4 + T淋巴细胞变化与雌二醇、孕酮及睾酮均呈正相关。 结论 颅脑损伤后早期雌二醇及后期孕酮增高对脑组织有一定的保护作用 ;T淋巴细胞及性激素减少是患者死亡的重要因素。
Objective To investigate the roles of sex hormones and T-cell phenotype in traumatic brain injury (TBI). Methods Within 12 hours, 1, 3 and 7 days after TBI, a dynamic observation and a correlative analysis were performed on CD4 + and CD8 + lymphocytes in the serum and on the changes of estradiol, progesterone and testosterone in the cerebrospinal fluid (CSF) and serum in all cases. Results The CD4 + and CD8 + lymphocytes were inhibited and decreased with injury severity. The estradiol and progesterone levels in serum and cerebrospinal fluid (CSF) increased within 12 hours after trauma in all groups. Estradiol increased markedly continuously within 1, 3 and 7 days and progesterone sustained high within seven days in GCS≤8 group, with a significant difference compared with others groups. The testosterone levels in serum and CSF decreased in the death group. There was a positive correlation between the changes of CD4 + lymphocytes and the levels of serum estradiol, progesterone and testosterone in the death group. Conclusions The increases of estradiol (in the early stage) and progesterone (in the late stage) after TBI may exert powerful protective effects on brain tissues. Decreases of sex hormones and T lymphocyte are important factors leading to death of patients.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2003年第12期724-727,共4页
Chinese Journal of Trauma
