周瑜;郭远瑾;梅元武;

• 1:华中科技大学同济医学院附属协和医院神经内科

摘要(Abstract)：

目的探讨不同时间点糖皮质激素联合抗病毒药物治疗对单纯疱疹病毒性脑炎预后的影响。方法小鼠随机分为对照组、HSV-1感染组(感染组)、阿昔洛韦治疗组(阿昔洛韦组)、地塞米松早期干预组(早期干预组)和地塞米松延迟干预组(延迟干预组)5组。采用流式细胞术测定脑组织小胶质细胞表面抗原CD11b,并用反转录-聚合酶链反应(RT-PCR)检测促炎性细胞因子TNF-αI、L-6表达,通过脑组织病理切片观察组织形态学变化。病毒感染后第5天对小鼠进行神经功能评分,2周后应用Kaplan-Meier法对各组小鼠进行生存率分析。结果病毒感染后第7天,与对照组比较,感染组脑组织CD11b阳性细胞及促炎性细胞因子明显增多(P<0.01),小胶质细胞激活,早期干预组可见小胶质细胞明显激活伴大量促炎性细胞因子产生(P<0.05);与感染组比较,阿昔洛韦组和延迟干预组小胶质细胞激活减少(P<0.01),促炎性细胞因子降至正常水平。延迟干预组与阿昔洛韦组相比小胶质激活减少(P<0.01),促炎性细胞因子表达及生存率无显著差异(P>0.05);与早期干预组比较,延迟干预组CD11b及促炎性细胞因子表达均明显减少(P<0.01),小鼠脑组织病理改变减轻,神经功能评分与生存率均明显提高(P<0.05)。结论在抗病毒治疗基础上,延迟给予糖皮质激素治疗可改善单纯疱疹病毒性脑炎预后。

关键词(KeyWords)： 糖皮质激素;单纯疱疹病毒性脑炎;小胶质细胞;细胞因子

Abstract:

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基金项目(Foundation):

作者(Author): 周瑜;郭远瑾;梅元武;

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参考文献(References)：

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