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发行周期:
月刊
主管单位:
上海市卫生健康委员会
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CN31-1366/R
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动态监测脓毒症患者辅助T淋巴细胞亚群变化及其临床意义
The clinical significance of continuous monitoring of helper T lymphocyte subset levels in septic patients

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DOI:
作者:
傅应云
fuyingyun
作者单位:
深圳市人民医院
Department of Respiratory Medicine, the Second School of Clinical Medicine of Jinan University;Shenzhen people’s hospital, Shenzhen 518020,China
关键词:
脓毒症；辅助T淋巴细胞；Th1/ Th2漂移；APACHE II评分
Sepsis；helper T- lymphocyte；Th1/Th2 floating；APACHEⅡ score
摘要:
目的　通过研究脓毒症患者外周静脉血辅助T淋巴细胞亚群动态变化，评价患者的免疫状态及与疾病的严重程度和预后的关系。方法　在患者被诊断为脓毒症后的第1、4、7、14、28天或出ICU 及死亡前最后一次抽取静脉血，应用流式细胞仪检测细胞表面分子标记为CD3+和CD8-的T淋巴细胞中的IL-4和IFN-γ含量，计算Th1、Th2 细胞百分比和Th1/Th2比值，从而判断外周血中的Thl/Th2漂移现象，同时记录当天的APACHE Ⅱ评分。结果 存活患者9例，死亡13例。死亡组较存活组Th1细胞、Th1/ Th2比值明显降低，Th2 细胞则明显增高 (P <0. 05)；Th1细胞、Th1/Th2比值与APACHEⅡ评分存在负相关。且死亡组患者从第4天开始上述趋势即显现，Th1细胞、Th1/ Th2比值进行性减少。结论 严重脓毒症患者存在明显的Th1/ Th2漂移。
Objective To monitor the changes of helper T lymphocyte subset levels in the patients with sepsis，and discuss the clinical significance on the patients with sepsis．Methods After the diagnosis of sepsis was made , patients’APACHE Ⅱscores, and the percentage of Th1、Th2 of peripheral blood and the ratio of Th1/Th2 were detected in the 1st , 4th , 7th , 14th and 28th days or the last time in ICU. Results Totally, 22 patients were enrolled in this study. Among them 9 survived and 13 died. The percentage of Th1 and Th1/Th2 ratio in the survival group were significantly lower than those in the dead group ( P< 0.05). The percentage of Th2 in the survival group was significantly higher than that in the dead group (P< 0.05).There was a negative correlation between the percentage of Th1、ratio of Th1/Th2 and APACHEⅡ scores. From the 4th day, the trend was showed in the survival group.Conclusions There is markedly Th1/Th2 floating in severe septic patients.

 

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