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目的研究胸腺五肽对脑梗死后T细胞、TNF-α水平双向调节治疗,一方面抑制梗死区过度的炎症反应;另一方面增强外周免疫功能,降低感染并发症的发生,达到免疫功能双向调节的理想疗效。方法 88例急性脑梗死患者随机分为对照组和治疗组,对照组予常规治疗(拜阿司匹林100mg qd、血栓通450mg qd、辛伐他汀20mg qn),治疗组予常规治疗加胸腺五肽(1支加入250ml生理盐水静滴1次/d)治疗14d。两组均于治疗前(脑梗死发生72h内)及治疗结束后均于清晨空腹时抽取血标本检测致脑细胞损伤的炎症因子(TNF-α)及免疫细胞因子(CD3+,CD4+,CD8+T细胞)的水平。结果治疗前两组血清浓度TNF-α无显著差别(P>0.05)。治疗14d后治疗组TNF-α浓度明显低于对照组(P<0.01),而两组治疗后TNF-α浓度均较治疗前有明显降低(P<0.01);治疗前两组CD3、CD4、CD8、CD4/CD8无显著差别(P>0.05),治疗14d后治疗组CD3、CD4、CD4/CD8明显高于对照组(P<0.01),治疗14d后治疗组CD8明显高于对照组(P<0.01)。结论胸腺五肽对急性脑梗死及并发免疫抑制综合征患者的双向免疫调节作用。
Objective To study the effect of thymopentin on the T cell and TNF-α levels after cerebral infarction. It not only inhibits the excessive inflammatory reaction in the infarct area, but also enhances the peripheral immune function and reduces the complication of infection, and achieves the bidirectional regulation of immune function The ideal effect. Methods Eighty-eight patients with acute cerebral infarction were randomly divided into control group and treatment group. The control group was given routine treatment (aspirin 100mg qd, thrombus and 450mg qd, simvastatin 20mg qn) Support 250ml saline infusion 1 / d) treatment 14d. Blood samples were taken from the blood samples to detect the inflammatory cytokines (TNF-α) and the immune cytokines (CD3 +, CD4 +, CD8 + T) in the brain tissue before treatment (within 72 hours after the onset of cerebral infarction) Cells) levels. Results There was no significant difference in serum TNF-α between the two groups before treatment (P> 0.05). After 14 days of treatment, the concentration of TNF-α in the treatment group was significantly lower than that in the control group (P <0.01), while the concentrations of TNF-α in the two groups were significantly decreased after treatment (P <0.01) CD8 and CD4 / CD8 in the treatment group were significantly higher than those in the control group (P <0.01) after 14 days of treatment. CD8 of the treatment group was significantly higher than that of the control group (P <0.01). Conclusions Thymopentin has a bidirectional immunomodulatory effect on acute cerebral infarction and patients with concurrent immunosuppressive syndrome.