患有脊髓损伤(SCI)的个体与没有SCI的个体相比具有更高的感染率。在这次审查中,通过检查他们的外周免疫细胞和标志物,研究有和没有创伤性SCI的个体之间的免疫状态差异。PubMed,科克伦,EMBASE,和OvidMEDLINE的搜索没有语言或日期限制。报告外周免疫标志物浓度和免疫细胞功能变化的研究包括与有和没有SCI的个体相比。对活动性感染参与者的研究,免疫性疾病,排除中枢神经系统(CNS)免疫标志物。审查遵循了PRISMA准则。使用随机效应模型通过加权平均差(WMD)测量效应估计值。使用国家心脏评估研究质量,肺,和血液研究所质量评估工具。54项研究(1813项SCI和1378项无SCI)为荟萃分析做出了贡献。白细胞(n=23,WMD0.78,95%CI0.17;1.38,I283%),中性粒细胞(n=11,WMD0.76,95%CI0.09;1.42,I289%),C反应蛋白(CRP)(n=12,WMD2.25,95%CI1.14;3.56,I295%),和IL6(n=13,WMD2.33,95%CI1.20;3.49,I297%)在SCI患者中高于没有SCI。临床因素(损伤阶段,损伤的完整性,交感神经支配受损,年龄,性别)和研究相关因素(样本量,研究设计,和血清vs.等离子体)部分解释了异质性。免疫细胞在SCI患者中表现出较低的功能能力。没有SCI的。大多数研究(75.6%)有中等偏倚风险。SCI患者的免疫状态不同于无SCI患者,在临床上受到损伤阶段的影响,损伤的完整性,交感神经支配受损,年龄,和性爱。这些结果提供了对监测和管理策略至关重要的信息,以有效改善SCI患者的免疫状态。
Individuals with spinal cord injury (SCI) have higher infection rates compared to those without SCI. In this
review, the immune status difference between individuals with and without traumatic SCI is investigated by examining their peripheral immune cells and markers. PubMed, Cochrane, EMBASE, and Ovid MEDLINE were searched without language or date restrictions. Studies reporting peripheral immune markers\' concentration and changes in functional capabilities of immune cells that compared individuals with and without SCI were included. Studies with participants with active infection, immune disease, and central nervous system (CNS) immune markers were excluded. The
review followed the PRISMA guidelines. Effect estimates were measured by Weighted Mean Difference (WMD) using a random-effects model. Study quality was assessed using the National Heart, Lung, and Blood Institute Quality Assessment Tool. Fifty-four studies (1813 with SCI and 1378 without SCI) contributed to the meta-analysis. Leukocytes (n = 23, WMD 0.78, 95% CI 0.17; 1.38, I2 83%), neutrophils (n = 11, WMD 0.76, 95% CI 0.09; 1.42, I2 89%), C-reactive protein (CRP) (n = 12, WMD 2.25, 95% CI 1.14; 3.56, I2 95%), and IL6 (n = 13, WMD 2.33, 95% CI 1.20; 3.49, I2 97%) were higher in individuals with SCI vs. without SCI. Clinical factors (phase of injury, completeness of injury, sympathetic innervation impairment, age, sex) and study-related factors (sample size, study design, and serum vs. plasma) partially explained heterogeneity. Immune cells exhibited lower functional capability in individuals with SCI vs. those without SCI. Most studies (75.6%) had a moderate risk of bias. The immune status of individuals with SCI differs from those without SCI and is clinically influenced by the phase of injury, completeness of injury, sympathetic innervation impairment, age, and sex. These results provide information that is vital for monitoring and management strategies to effectively improve the immune status of individuals with SCI.