急性肺损伤不同时期白细胞粘附分子的表达及其意义  

Expression of leukocyte adhesion molecules at different stage in acute lung injury

作　　者：马希刚[1] 张珍祥[1] 徐永键[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院呼吸科,湖北武汉430030

出　　处：《中国实用内科杂志》2006年第12期1875-1877,共3页Chinese Journal of Practical Internal Medicine

摘　　要：目的探讨白细胞粘附分子在急性肺损伤(ALI)/急性呼吸窘迫综合征(ARDS)发病机制中的作用。方法采用流式细胞术,用单克隆抗体定量测定2004年6月至2005年12月华中科技大学同济医学院附属同济医院重症监护病房的26例ALI患者、18例ARDS患者和15名健康人外周血中白细胞粘附分子CD11a、CD11b和CD18的阳性表达率,并比较治愈组与死亡组患者白细胞粘附分子CD11a、CD11b和CD18的阳性表达率。结果ALI组和ARDS组外周血中性粒细胞和单核细胞表面的CD11a、CD11b和CD18明显高于健康对照组(P<0.01),ARDS组中性粒细胞、单核细胞和淋巴细胞表面的CD11a、CD11b和CD18,明显高于ALI组(P<0.05);死亡组患者中性粒细胞表面的CD11a、CD11b和CD18明显高于治愈组(P<0.05)。结论ALI患者通过中性粒细胞和单核细胞CD11a/CD18、CD11b/CD18的表达上调,ARDS患者通过中性粒细胞、单核细胞和淋巴细胞表面CD11a/CD18、CD11b/CD18的表达上调,参与各自疾病的病理发展过程。中性粒细胞CD11a/CD18、CD11b/CD18的表达水平与预后密切相关。Objective To study the leukocyte adhesion molecules in the pathogrnesis of ALI and ARDS. Methods The positive expression rates of CD11 a, CD11 b and CD18 in peripheral blood were quantitatively analyzed by flow cytometry using monoelonal antibodies in 26 cases of ALI, 18cases of ARDS and 15 healthy controls. Results The expression rates of CD11a, CD11b and CD18 in polymorphonuclear neutrophils and monocytes from the ALI group and ARDS group were much higher than those in the control group （P 〈0. 01 ）. The expression rates of CD11a, CD11b and CD18 in polymorphonuclear neutropils, monocytes and lymphocytes from the ARDS group were much higher than those in the ALI group （P 〈0. 05）. The expression rates of CD11a、 CD11b and CD18 in neutropilses from the death group were much higher than those in the cure group （P 〈 0.05）. Conclusion Uprogulation expression of CD11a/CD18 and CD11 b/CD18 in polymorphonuclear neutrophils and monocytes in ALI, CD11a/CD18 and CD11 b/CD1 8 in neutrophils, monocytes and lymphocytes in ARDS may promote adhesion of leukocytes with endothelial cells, which may play an important role in the pathogenic process.

关 键 词：白细胞 粘附分子 急性肺损伤 急性呼吸窘迫综合征 

分 类 号：R5[医药卫生—内科学]