关键词: 高血压; 脑出血; T淋巴细胞亚群; 免疫功能

Abstract:

Objective To observe the dynamic changes of T lymphocyte subsets in peripheral blood of patients with hypertensive intracerebral hemorrhage, and to explore the immunosuppression state after hypertensive intracerebral hemorrhage. Methods This prospective study included 30 patients with mild (GCS 12-15 points), moderate (GCS 9-11) and severe (GCS 3-8 points) hypertensive cerebral hemorrhage according to the GCS score at admission. 30 patients with essential hypertension without cerebral hemorrhage were selected as the controls. Venous blood was collected on day1, 3, 7, 14 and 28 after intracerebral hemorrhage in hypertensive intracerebral hemorrhage group and on the second day of hospitalization in the control group, to detect the proportion of peripheral blood CD4+ and CD8+ lymphocytes and calculate the CD4+/CD8+ ratio, and analyze the trend of changes in the levels of CD4+ and CD8+ T lymphocytes in patients with hypertensive cerebral hemorrhage. Results In the differences of the groups, the proportion of CD4+ and CD8+ lymphocytes in the mild, medium, and severe hypertensive intracerebral hemorrhage subgroups were all lower than that in control group on day 1, 3, and 7; the proportion of CD4+ and CD8+ only in severe subgroup on day 14 were lower than that in control group; there was no statistical difference in the proportion of CD4+and CD8+ cells among the 4 subgroups on day 28. In the changes trend, the proportion of CD4+ and CD8+ lymphocytes in all the hypertensive cerebral hemorrhage patients showed a trend of first decreasing and then increasing after onset. The proportion of CD4+ lymphocytes was lowest on day 3, and then gradually increased; the proportion of CD8+ lymphocytes was the lowest on day 1, then gradually increased, and basically rose to the level of control group on day 28. Conclusions The percentage of T-lymphocytes (CD4+, CD8+) all decreased firstly and then returned to normal level after cerebral hemorrhage. In the early stage (within 7 days after onset), the level of immune cells was significantly lower than the normal level, indicating that the immune function is in suppression state. The immune cells level basically returned to normal level on day14 after cerebral hemorrhage in mild and moderate hypertensive intracerebral hemorrhage patients, while that returned to normal level on day 28 in severe patients.

Key words: Hypertension; Cerebral hemorrhage; T lymphocyte subset; Immunologic function