探讨脑脊液中CD4⁺CD25⁺调节性T细胞（Treg）、可溶性细胞间黏附分子（sICAM-1）及B细胞活化因子（BAFF）与动脉瘤蛛网膜下腔出血（SAH）的相关性。

随机选择内蒙古医科大学附属医院神经外科2015年3月至2016年12月120例SAH患者作为观察组，选择同期健康体检人群40例作为对照组，均行脑脊液CD4⁺CD25⁺Treg、sICAM-1及BAFF水平检测，组间比较采用t检验，并采用Pearson参数法分析其与疾病严重程度（Hunt-Hess分级法）的相关性。

观察组CD4⁺CD25⁺Treg水平（2.52±0.73）﹪低于对照组（4.52±1.08）﹪，差异有统计学意义（t =-12.563，P < 0.01）；sICAM-1（853.25±155.36）pg/ml及BAFF（586.23±163.73）pg/ml水平高于对照组sICAM-1（315.65±132.58）pg/ml，（t =-19.569，P < 0.01）及BAFF（272.66?±?142.58）pg/ml,（t?=-11.426，P < 0.01）；随着Hunt-Hess分级的增加，SAH患者CD4⁺CD25⁺Treg水平呈逐渐降低趋势（3.12?±?0.82）﹪、（2.42?±?1.05）﹪、（1.28?±?0.61）﹪，sICAM-1（627.21?±?152.56）pg/ml、（794.78?±?106.36）pg/ml、（896.56?±?110.52）pg/ml及BAFF（395.32?±?162.53）pg/ml、（589.62?±?170.43）pg/ml、（789.61?±?173.52）pg/ml水平呈逐渐上升趋势，3组比较差异有统计学意义（F = 7.214，12.372，11.581，P均< 0.01）；CD4⁺CD25⁺Treg与SAH病情程度呈负相关（r =-0.824，P < 0.01）、sICAM-1、BAFF水平与病情程度成正相关（r = 0.922，0.472，P均< 0.01）。

CD4⁺CD25⁺Treg是颅内动脉瘤患者的一种保护因素，其水平的含量降低，动脉瘤破裂后SAH的风险程度增加，sICAM-1、BAFF参与SAH的发生，其水平增高可加重动脉瘤SAH的炎症反应。

To investigate the correlation of CD4⁺CD25⁺Treg, sICAM-1 and BAFF in cerebrospinal fluid (CSF) with aneurysmal subarachnoid hemorrhage.

120 theaneurysmal subarachnoid hemorrhage (SAH) patients treated in the Department of Neurosurgery, the Affiliated Hospital of Inner Mongolia Medical University from March 2015 to December 2016 were randomly selected as an observation group, and 40 healthy people we selected as a control group at the same period. CD4⁺CD25⁺Treg, sICAM-1 and BAFF in cerebrospinal fluid in both groups were detected.Ttest was used to compare among groups and Pearson parameter method was used to analyze the correlation with disease severity (Hunt-Hess classification method).

The CD4⁺CD25⁺Treg of the observation group (2.52±0.73)﹪was significantly lower than that of the control group (4.52±1.08)﹪, which was statistically different (t=-12.563,P< 0.01); sICAM-1 (853.25±155.36) pg/ml and BAFF (586.23±163.73) pg/ml levels in the observation group were significantly higher than those of the control group sICAM-1:(315.65±132.58) pg/ml, (t= -19.569,P?< 0.01) and BAFF:(272.66±142.58) pg/ml (t = -11.426, P < 0.01), which were statistically different (P< 0.05); with the increase of Hunt-Hess grade, CD4⁺CD25⁺Treg level in SAH patients was gradually decreased:(3.12±0.82)﹪and(2.42±1.05)﹪and(1.28±0.61), sICAM-1(627.21±152.56) pg/ml, (794.78±106.36) pg/ml, (896.56±110.52) pg/ml and BAFF (395.32±162.53) pg/ml, (589.62?±?170.43) pg/ml, (789.61±173.52) pg/ml levels were increased gradually, which were statistically different between 3 groups (F= 7.214, 12.372, 11.581,P< 0.01); CD4⁺CD25⁺Treg and SAH severity was negatively correlated (r=-0.824,P< 0.01), sICAM-1 and BAFF levels and the severity of disease were negatively correlated (r= 0.922, 0.472,P< 0.01) .

CD4⁺CD25⁺Treg is a protective factor for patients with intracranial aneurysms. Decrease of CD4⁺CD25⁺Treg increases the risk of SAH after aneurysm rupture. sICAM-1, BAFF are involved in SAH, the increase of which can increase the level of inflammation aneurysmal SAH.