Objective To observe the changes of cellular and molecular immune in the peripheral blood of patients with acute spontaneous intracerebral hemorrhage (ICH), and to evaluate the correlations between the neurological function of patients with ICH and immune changes.

Methods 25 spontaneous ICH patients admitted in Nantong Third People's Hospital from January 2022 to December 2022 were recruited as the ICH group. 30 persons underwent health examination in the physical examination center of this hospital at the same time were recruited as the health control group. The admission Glasgow coma scale (GCS) score and modified Rankin scale (mRS) score on Day 90 after the onset of the disease and routine blood indexes were collected. The concentrations of adrenocorticotropic hormone (ACTH), cortisol and cytokines in peripheral blood were measured by enzyme-linked immunosorbent assay (ELISA). The count of lymphocytes and subpopulation cells in peripheral blood were measured by flow cytometry (FCM). The associations of GCS score with immune indexes were analyed by Pearson coefficient.

Results Compared with healthy control group, the levels of IL-4, IL-6, IL-10 and TNF-α in ICH group increased significantly (P < 0.01); the counts of white blood cells, monocytes, neutrophils and NK cells in ICH group increased (P < 0.01); the counts of lymphocytes, eosinophils and T cells in ICH group decreased (P < 0.001). The GCS score was negatively correlated with IL-17A and monocyte count (r values were -0.493 2 and -0.533 8, P < 0.05), and the lesion volume was positively correlated with IL-4 and leukocyte and monocyte counts (r values were 0.479 5, 0.509 2 and 0.575 8, P < 0.05). The proportion of patients with hypertension in the poor prognosis (mRS score ≥ 4 points) group was significantly higher (P < 0.05).

Conclusions The ICH might lead to the significant changes of peripheral immune system, and immune function of patients has some associations with GCS score and lesion volume.