本文選題：神經(jīng)梅毒 + 細(xì)胞免疫��； 參考：《廈門大學(xué)》2014年碩士論文

【摘要】：梅毒是由梅毒螺旋體(Treponema pallidum, Tp)引起的嚴(yán)重危害人類健康的性傳播性疾病。Tp可以在疾病的任何階段入侵中樞神經(jīng)系統(tǒng),引起神經(jīng)梅毒。由于神經(jīng)梅毒臨床癥狀復(fù)雜,誤診與漏診率極高,早期診斷非常重要。目前,神經(jīng)梅毒的診斷主要是依靠患者的病史、臨床癥狀與體征、血液和腦脊液(CSF)的相關(guān)實(shí)驗(yàn)室檢查。本課題分析了52例HIV陰性的神經(jīng)梅毒患者外周血淋巴細(xì)胞亞群及CSF常規(guī)、生化、免疫實(shí)驗(yàn)室指標(biāo)的變化,通過兔感染模型,分析經(jīng)Tp感染后,新西蘭兔CSF RPR、TPPA、常規(guī)及生化指標(biāo)隨感染時間不同的變化情況。探討神經(jīng)梅毒患者細(xì)胞免疫和體液免疫相關(guān)實(shí)驗(yàn)室指標(biāo)對臨床的應(yīng)用價值。實(shí)驗(yàn)結(jié)果表明CD3+T淋巴細(xì)胞與CD3+CD4+T淋巴細(xì)胞在炎癥反應(yīng)最劇烈的早期神經(jīng)梅毒患者體內(nèi)含量最低,與無癥狀和晚期神經(jīng)梅毒患者相比,早期神經(jīng)梅毒患者的CD3+CD4+/CD3+CD8+比值差異最大,反映了早期神經(jīng)梅毒患者體內(nèi)存在明顯的細(xì)胞免疫失衡。與正常對照組相比,神經(jīng)梅毒患者的CD3+CD8+T淋巴細(xì)胞數(shù)量升高,NK細(xì)胞數(shù)量下降。CD3+CD8+T淋巴細(xì)胞和NK細(xì)胞在不同臨床階段神經(jīng)梅毒患者及健康體檢者間的含量變化均具有統(tǒng)計(jì)學(xué)差異。CSF白細(xì)胞(WBC)、CSF蛋白、CSF自蛋白、白蛋白商、CSFIgG、CSF IgA、IgG指數(shù)和IgA指數(shù)的升高,CSF乳酸脫氫酶(LDH)的降低都與神經(jīng)梅毒的進(jìn)展密切相關(guān)。與Nichols標(biāo)準(zhǔn)株相比,臨床分離的野生株感染新西蘭兔引起的免疫反應(yīng)較弱。臨床不同來源的Tp野生株感染新西蘭兔,導(dǎo)致新西蘭兔的CSF WBC、CSF蛋白、CSF白蛋白以及CSF LDH隨病程的進(jìn)展,含量升高到一定水平又逐漸下降,這與不同臨床階段神經(jīng)梅毒患者CSF相應(yīng)指標(biāo)表現(xiàn)類似。血液和腦脊液的相關(guān)實(shí)驗(yàn)室檢測對于神經(jīng)梅毒的診斷和病情監(jiān)測具有重要的作用。
[Abstract]:Syphilis is a sexually transmitted disease caused by Treponema pallium (TP), which can invade the central nervous system and cause neurosyphilis at any stage of the disease. Due to the complex clinical symptoms of neurosyphilis and high misdiagnosis and missed diagnosis, early diagnosis is very important. At present, the diagnosis of neurosyphilis mainly depends on the laboratory examination of the patient's history, clinical symptoms and signs, blood and cerebrospinal fluid (CSF). The changes of peripheral blood lymphocyte subsets and CSF routine, biochemical and immunological indexes in 52 HIV-negative neurosyphilis patients were analyzed. New Zealand rabbit CSF RPRP TPPA, routine and biochemical parameters varied with infection time. To investigate the clinical value of laboratory indexes related to cellular and humoral immunity in patients with neurosyphilis. The results showed that CD3 T lymphocytes and CD3 CD4 T lymphocytes were the lowest in patients with early neurosyphilis, who had the most acute inflammatory reaction, compared with asymptomatic and advanced neurosyphilis patients. The ratio of CD3 CD4 / CD 3 CD 8 in patients with early neurosyphilis was significantly different, which reflected the obvious imbalance of cellular immunity in patients with early neurosyphilis. Compared with the normal control group, Increased number of CD3 CD8 T lymphocytes in patients with neurosyphilis; decreased number of NK cells; changes of CD3 CD8 T lymphocytes and NK cells in patients with neurosyphilis at different clinical stages and healthy controls. CSF White blood cell (WBC) CSF protein and CSF self protein, The increase of IgG index and IgA index of CSF IgGG CSF and the decrease of LDHs of CSF lactate dehydrogenase are closely related to the progression of neurosyphilis. Compared with Nichols standard strain, the immune response of the isolated wild strain was weaker than that of the New Zealand rabbit. Wild strains of TP from different clinical sources were infected in New Zealand rabbits, which led to the increase of CSF WBC- CSF protein, CSF albumin and CSF LDH, which increased to a certain level and then decreased gradually with the progression of the course of the disease. This is similar to the corresponding CSF index in patients with neurosyphilis at different clinical stages. Laboratory tests of blood and cerebrospinal fluid play an important role in the diagnosis and monitoring of neurosyphilis.
【學(xué)位授予單位】：廈門大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R759.13

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本文編號：1995730