ОСОБЕННОСТИ ИММУННОГО СТАТУСА У ПАЦИЕНТОВ В ОСТРОМ ПЕРИОДЕ ИШЕМИЧЕСКОГО ИНСУЛЬТА

Abstract

To study the immune status of patients in an acute period of ischemic stroke, a clinical and immunological observation of 45 patients was performed. At the 2nd day after the onset of the disease, an increase in the leukocyte count (p˂0.01) and a decrease in lymphocytes (p˂0.05), T-lymphocytes (CD3+) (p<0.01), T-helpers (CD4+) (p˂0.01) and cytotoxic T-lymphocytes (CD8+) (p˂0.05) were observed. There was also a tendency to decrease the content of natural killers (NK cells, CD16+) and cells that express the receptors for IL-2 (CD25+) (p˃0.05). In the humoral immunity an increase in the number of B-lymphocytes (CD20+) (p˂0.05) and dysgammaglobulinaemia due to the tendency to hyperfunction IgA and IgM (p˃0.05) and an increase in IgG (p˂0.05) was observed. Deviation of the immune status of normal values was more pronounced with increasing severity of neurological symptoms and infarct size. With a moderate and severe stroke on the NIHSS scale and the infarct size of more than 15 mm, more pronounced lymphopenia (p˂0.05) was noted with a significant decrease in the T-lymphocyte (CD3+) (p˂0.05), T-lymphocyte subpopulations (CD4+; p˂0.05) and CD8+; p<0.005), as well as NK cells (CD16+) and cells expressing receptors for IL-2 (CD25+) (p˃0.05). Thus, these studies demonstrate the involvement of the immune system in a complex set of reactions involved in the development of cerebral accidents and suggest an increased susceptibility of these patients to the development of infectious complications. The lack of immune status changes against standard therapy requires an immune-corrective therapy (in case of violations of basic parameters of the immune system).