目的 分析在高血压基底节区脑出血治疗中超早期经外侧裂入路对患者免疫功能的影响。方法 回顾性分析我院2012-02至2014-02收治的191例接受超早期经外侧裂入路治疗的高血压基底节区脑出血患者的临床资料,观察其治疗前后B淋巴细胞、免疫球蛋白及补体水平变化。结果 患者出院前CD19⁺-CD25⁺(0.91%±0.29%)、CD19⁺-CD25^-(10.74%±2.33%)较入院后(1.36%±0.58%,12.27%±4.01%)显著降低(P＜0.05),其总淋巴细胞数差异无统计学意义;患者入院后及出院前IgA、IgG、IgM及C₃水平比较,差异均无统计学意义。191例均获得有效随访,其中2例死亡,均因肺部感染。ADL分级:Ⅰ级43例,Ⅱ级101例,Ⅲ级35例,Ⅳ级7例,Ⅴ级3例,有效率94.7%(179/189)。结论 超早期经外侧裂入路可有效改善高血压基底节区脑出血患者体液免疫紊乱状态,但对其免疫球蛋白和补体水平无明显影响。

Objective To analyze ultra early transsylvian fissure in the effect on the immune function of the patients in the treatment of hypertensive cerebral hemorrhage in basal ganglia. Methods The retrospective analysis of the clinical data of an ultra early transsylvian fissure treatment of hypertensive cerebral hemorrhage in basal ganglia patients in this hospital from 2012 February to 2014 year in February 191 cases was carried out. The change in B lymphocyte, immunoglobulin and complement level before and after the treatment was observed. Results The patients before discharge CD19⁺-CD25⁺(0.91%±0.29%), CD19⁺-CD25^-(10.74%±2.33%) decreased significantly after admission (P＜0.05), the total number of lymphocytes was not statistically significant; before and after the IgA, IgG, IgM and C₃ levels were not statistically significant. 191 patients obtained effective follow-up, 2 patients died, all because of pulmonary infection. ADL grade: Ⅰ grade 43 cases, Ⅱ grade 101 cases, 35 cases of grade Ⅲ, 7 cases of grade IV, 3 cases of grade V, with an efficiency of 94.7% (179/189). Conclusions Ultra early transsylvian approach can effectively improve the humoral immune disorder in patients with hypertensive cerebral hemorrhage in basal ganglia, but has no significant effect on the immunoglobulin and complement level, in the clinical treatment. In the future, we should focus on immunoglobulin and complement levels of improvement, in order to further improve the prognosis of the patients.