本文選題：森林腦炎 + 森林腦炎病毒��； 參考：《內(nèi)蒙古民族大學(xué)》2017年碩士論文

【摘要】：目的:本文通過(guò)流式微球捕獲芯片技術(shù)及流式細(xì)胞術(shù)分別檢測(cè)森林腦炎患者與健康體檢者外周血細(xì)胞因子及淋巴細(xì)胞亞群水平,對(duì)森林腦炎患者組與對(duì)照組、森林腦炎患者病情中重度組與輕度組、急性期與恢復(fù)期之間進(jìn)行比較分析,研究細(xì)胞因子及淋巴細(xì)胞亞群水平與森林腦炎免疫炎癥反應(yīng)的關(guān)系,對(duì)森林腦炎患者判斷病情輕重、預(yù)后評(píng)估提供重要的免疫學(xué)指標(biāo)。方法:(1)收集于內(nèi)蒙古民族大學(xué)第二臨床醫(yī)學(xué)院(內(nèi)蒙古林業(yè)總醫(yī)院)神經(jīng)內(nèi)科2015年5月~2016年9月期間住院的患者,有蜱叮咬并明確診斷森林腦炎患者79例。參照職業(yè)性森林腦炎診斷標(biāo)準(zhǔn)GBZ88-2002,將TBE患者按照病情輕重不同分為中重度組28例和輕度組51例;根據(jù)患者病程時(shí)期不同分為急性期47例和恢復(fù)期32例。收集同時(shí)期來(lái)醫(yī)院的健康體檢者作為實(shí)驗(yàn)對(duì)照組20例。(2)采集患者急性期發(fā)病3天內(nèi)和恢復(fù)期時(shí)血樣3~5m L,裝于EDTA抗凝紫帽管及含分離膠促凝黃帽管。(3)流式微球捕獲芯片技術(shù)及流式細(xì)胞術(shù)分別檢測(cè)森林腦炎患者外周血細(xì)胞因子及淋巴細(xì)胞亞群水平。(4)計(jì)數(shù)資料采用卡方檢驗(yàn);計(jì)量資料符合正態(tài)分布的樣本用均數(shù)(標(biāo)準(zhǔn)差)表示,組間比較采用t檢驗(yàn);偏態(tài)分布的樣本用中位數(shù)(四分位間距)表示,組間比較采用非參-獨(dú)立樣本秩和檢驗(yàn);α=0.05為檢驗(yàn)水準(zhǔn)。結(jié)果:(1)TBE患者組與對(duì)照組的差異(1)細(xì)胞因子:TBE患者組與對(duì)照組比較,血清IL-17A、IFN-γ、TNF-α、IL-10、IL-6、IL-4和IL-2水平明顯升高,差異有統(tǒng)計(jì)學(xué)意義(p0.05)。(2)淋巴細(xì)胞亞群:TBE患者組與對(duì)照組比較,外周血B細(xì)胞百分比明顯升高,差異有統(tǒng)計(jì)學(xué)意義(p0.05);而CD3~+、CD8~+、CD4~+、CD4~+/CD8~+、NK和Treg細(xì)胞指標(biāo)在兩組之間差異無(wú)統(tǒng)計(jì)學(xué)意義(p0.05)。(2)TBE患者中重度組與輕度組的差異(1)細(xì)胞因子:TBE患者中重度組與輕度組比較,血清IL-6水平明顯升高,差異有統(tǒng)計(jì)學(xué)意義(p0.05);而IL-17A、IFN-γ、TNF-α、IL-10、IL-4和IL-2水平在兩組之間差異無(wú)統(tǒng)計(jì)學(xué)意義(p0.05)。(2)淋巴細(xì)胞亞群:TBE患者中重度組與輕度組比較,外周血CD3和CD8指標(biāo)明顯降低,B和Treg細(xì)胞百分比明顯升高,差異有統(tǒng)計(jì)學(xué)意義(p0.05);而CD4~+、CD4~+/CD8~+和NK細(xì)胞指標(biāo)在兩組之間差異無(wú)統(tǒng)計(jì)學(xué)意義(p0.05)。(3)TBE患者急性期與恢復(fù)期的差異(1)細(xì)胞因子:TBE患者急性期與恢復(fù)期比較,血清IL-6水平明顯升高,差異有統(tǒng)計(jì)學(xué)意義(p0.05);而血清IL-17A、IFN-γ、TNF-α、IL-10、IL-4和IL-2水平在兩組之間差異無(wú)統(tǒng)計(jì)學(xué)意義(p0.05)。(2)淋巴細(xì)胞亞群:TBE患者急性期與恢復(fù)期比較,外周血CD3~+、CD8~+指標(biāo)明顯降低,CD4~+、CD4~+/CD8~+和B細(xì)胞指標(biāo)明顯升高(p0.05);而NK和Treg細(xì)胞百分比在兩組之間差異無(wú)統(tǒng)計(jì)學(xué)意義(p0.05)。結(jié)論:(1)森林腦炎患者外周血IL-17A、IFN-γ、TNF-α、IL-10、IL-6、IL-4、IL-2及B細(xì)胞水平變化,可能在森林腦炎免疫發(fā)病機(jī)制中發(fā)揮重要作用。(2)外周血IL-6及CD3~+、CD8~+、B和Treg細(xì)胞指標(biāo)在TBE患者中重度組明顯變化,可作為森林腦炎患者判斷病情輕重的指標(biāo)。(3)外周血IL-6及CD3~+、CD8~+、D4+、CD4~+/CD8~+、B細(xì)胞指標(biāo)變化,可作為森林腦炎患者預(yù)后評(píng)估的指標(biāo)。
[Abstract]:Objective: To investigate the level of peripheral blood cytokines and lymphocyte subsets in the patients with forest encephalitis and health examiners by flow microsphere capture chip technology and flow cytometry, and to compare and analyze the patients with forest encephalitis and the control group, the severe group and the mild group, the acute period and the recovery period, and the study of the patients with forest encephalitis. The relationship between cell factor and lymphocyte subgroup level and immune inflammatory response of forest encephalitis can provide important immunological indexes for judging the severity and prognosis of forest encephalitis patients. Methods: (1) collected in the neurology department of the second clinical medicine hospital of Inner Mongolia University for the Nationalities (Inner Mongolia General Hospital of Lin Ye) in September ~2016 May 2015. In the hospital, there were 79 patients with tick bite and definite diagnosis of forest encephalitis. According to the diagnostic standard of occupational forest encephalitis GBZ88-2002, the patients were divided into 28 cases and 51 mild groups according to the severity of the disease. 47 cases of acute period and 32 cases were divided into 32 cases according to the period of disease course. 20 cases were used as the experimental control group. (2) the blood sample 3~5m L was collected within 3 days and the convalescence period of the patients during the acute period, which was installed in the EDTA anticoagulant purple caps tube and the separating glue promoting yellow cap tube. (3) the flow cytometry and flow cytometry were used to detect the peripheral blood cell factor and lymphocyte subgroup in the peripheral blood of the patients with forest encephalitis. (4) the counting data were collected. Using the chi square test; the measurement data conformed to the normal distribution of the sample average number (standard deviation), and the t test was used in the group. The sample used in the partial distribution was expressed as the median (four division spacing), the group was compared with the non parametric independent sample rank and test; the alpha =0.05 was the test level. (1) the difference between the TBE patient group and the control group (1) the cytokine: TB Compared with the control group, the level of serum IL-17A, IFN- gamma, TNF- a, IL-10, IL-6, IL-4 and IL-2 increased significantly in the E patients group, and the difference was statistically significant (P0.05). (2) the lymphocyte subgroup: the percentage of B cells in the peripheral blood increased significantly in the peripheral blood, and the difference was statistically significant (P0.05). The difference between the two groups was not statistically significant (P0.05). (2) the difference between the moderate and severe group of TBE patients (1) cytokine: the level of serum IL-6 in the moderate and severe group of TBE patients was significantly higher than that in the mild group, and the difference was statistically significant (P0.05), while IL-17A, IFN- gamma, TNF- a, IL-10, IL-4 and IL-2 were not statistically different among the groups. Significance (P0.05). (2) lymphocyte subsets: compared with mild group, the index of CD3 and CD8 in peripheral blood significantly decreased and the percentage of B and Treg cells increased significantly (P0.05), while CD4~+, CD4~+/CD8~+ and NK cell indexes were not statistically significant (P0.05). (3) acute and recovery phase of TBE patients. Difference (1) cytokine: TBE patients' acute phase and recovery period, serum IL-6 level was significantly higher, the difference was statistically significant (P0.05), while serum IL-17A, IFN- gamma, TNF- a, IL-10, IL-4 and IL-2 levels were not statistically significant between the two groups (P0.05). (2) lymphocyte subgroups: TBE patients compared with the recovery period, peripheral blood CD3~+ The index of 8~+, CD4~+, CD4~+/CD8~+ and B cells increased significantly (P0.05), while the percentage of NK and Treg cells had no significant difference between the two groups (P0.05). Conclusion: (1) the peripheral blood IL-17A, IFN- gamma, TNF- alpha in the peripheral blood of the patients with forest encephalitis may play a role in the immune pathogenesis of forest encephalitis. (2) the indexes of IL-6 and CD3~+, CD8~+, B and Treg in peripheral blood were significantly changed in the moderate and severe group of TBE patients. It could be used as an index to judge the severity of the disease in the patients with forest encephalitis. (3) the peripheral blood IL-6 and CD3~+, CD8~+, D4+, CD4~+/CD8~+, and the changes of B cell indexes could be used as indicators for evaluating the prognosis of the patients with forest encephalitis.
【學(xué)位授予單位】：內(nèi)蒙古民族大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R512.34

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