Abstract: 【Abstract】〓Objective〓To investigate the dynamic changes of peripheral blood CD8+CD28-T cells and clinical significance in patients with cerebral hernia. Methods〓A total of 77 patients of severe brain injury were divided into two groups: cerebral hernia (A group, n=36) and no-cerebral hernia (B group, n=41), 32 healthy subjects were in control group (C group), the level of CD4+ CD25+ and the percentage of TGF-β1, IL-10 in peripheral blood was analyzed with flow cytometry. All variables were observed in group A and B at post-traumatic 3, 6, 12 h. Results〓Difference of three groups in CD8+ CD28- T cells, TGF-β1 and IL-10 overall was significant (P<0.05), but no statistically significant difference between group B and group C, all variables in group A was significantly lower than group B and group C (P<0.05). The level of CD8+ CD28-T cells, TGF-β1 and IL-10 had no significant difference in group B for 3, 6, 12 h. Compared with group B, CD8+ CD28- T cells, TGF-β1 and IL-10 in group A of three different time points showed a progressive decline, difference between any two time points was significant. Conclusion〓One important cellular immunological characteristics of cerebral hernia is the significant decrease of CD8+ CD28-T cells, especially the progressive decline of which within 12 h are closely related to disease progression.

Key words: Craniocerebral injury, Cerebral hernia, CD8+ CD28- T cells, Cytokines

摘要： 【摘要】 目的 探讨脑疝患者外周血CD8+CD28-T细胞的动态变化与临床意义。方法〓收集36例脑疝组(A组)患者外周血,以41例未出现脑疝的重型颅脑损伤患者(B组)及32例健康人(C组)作为对照,采用流式细胞术检测外周血CD8+CD28-T细胞及其胞内转化生长因子β1(TGF-β1)及白介素10(IL-10)百分含量。分别在伤后3 h、6 h及12 h观察A及B组患者外周血CD8+CD28-T细胞、TGF-β1及IL-10变化。结果〓三组CD8+CD28-T细胞、TGF-β1及IL-10总体差异均有显著性(P < 0.05),但B组与C组无统计学差异,而A组上述三者均显著低于另外B及C组(P < 0.05)。B组患者在伤后3 h、6 h及12 h的CD8+CD28-T细胞、TGF-β1及IL-10差异均无统计学意义|A组患者3 h、6 h及12 h的CD8+CD28-T细胞、TGF-β1及IL-10均呈进行性下降,表现为任意两个时间点的差异均有统计学意义(P < 0.05),且均显著低于B组(P < 0.05)。结论〓CD8+CD28-T细胞显著下降是脑疝患者的一个重要细胞免疫学特征,其伤后12h内进行性下降与病情进展密切相关。

关键词: 颅脑损伤, 脑疝, CD8+CD28-T细胞, 细胞因子