烧伤延迟复苏对CD14^+单核细胞HLA-DR表达率和外周血淋巴细胞凋亡率的影响  

Influence of delayed resuscitation to the expression of HLA-DR antigen on CD14^+ monocyte and lymphocyte apoptosis rate in peripherial blood of burn patients

作　　者：于燕[1] 杨红明[1] 柴家科[1] 胡森[1] 雷树红[2] 张冬青[2] 张国安[3] 陶白江 贺立新 杨国兴[1] 李凤玉[1] 姚咏明[1] 

机构地区：[1]解放军总医院第一附属医院全军烧伤研究所,北京100037 [2]解放军总医院第一附属医院检验科,北京100037 [3]积水潭医院烧伤科,北京100035 [4]二炮总医院烧伤科,北京100089 [5]右安门医院烧伤科,北京100054

出　　处：《感染．炎症．修复》2007年第3期144-147,共4页Infection Inflammation Repair

基　　金：首都医学发展科研基金联合攻关项目(2002-1010)

摘　　要：目的:探讨烧伤延迟复苏对CD14+单核细胞人类白细胞组织相容性抗原-DR(HLA-DR)表达率和外周血淋巴细胞凋亡率的影响及其机制。方法:50例烧伤面积大于30%的烧伤患者,按伤后是否及时有效复苏分为延迟复苏组和非延迟复苏组,于伤后1、3、7、14、28d取外周血。流式细胞术检测CD14+单核细胞HLA-DR表达率和外周血淋巴细胞凋亡率。20例健康体检者外周血检测上述指标作为对照。结果:烧伤患者外周血CD14+单核细胞HLA-DR表达率明显低于正常对照组(P均<0.01),延迟复苏患者明显低于非延迟复苏患者(P<0.05或P<0.01)。烧伤患者外周血淋巴细胞凋亡率明显高于正常对照组(P<0.05),延迟复苏患者明显高于非延迟复苏患者,伤后7和28d差异有显著性(P<0.05)。结论:烧伤患者免疫功能低下,动态检测患者的免疫功能状态对患者预后具有指导意义。Objective：To investigate the influence of delayed resuscitation on the expression of HLA-DR antigen on CD14^＋ monocytes and lymphocyte apoptosis rate in peripherial blood of burn patients. Methods： Fifty patients with a total burn surface area of at least 30 % were divided into delayed resuscitation group and prompt resuscitation group. Peripheral blood was collected on postburn days 1, 3, 7, 14 and 28. Twenty healthy volunteers served as controls. Expression of HLA-DR antigen on CD14^＋ monocytes and lymphocyte apoptosis rate of the peripheral blood were determined by direct immunofluorescence on a flow cytometer. Results：Expression of HLA-DR antigen on CD14^＋ monocyte in peripherial blood of burn patients was obviously lower than that of controls （P〈0.01）, and they were significantly lower in delayed resuscitation group than in prompt resuscitation group（P〈0. 05 or P 〈0. 01）. Lymphocyte apoptosis rate of burn patients was much higher than that of controls（P〈0.05）. Lymphocyte apoptosis rate in delayed resuscitation group was higher than that in prompt resuscitation group, and the difference was statistically significant on postburn days 3 and 28. Conclusion： Immune function is suppressed in burn patients. Expression of HLA-DR antigen on CD14^＋ monocytes and lymphocyte apoptosis rate might be useful parameters for monitoring the immune function of burn patients.

关 键 词：烧伤 延迟复苏 CD14^+单核细胞 人类白细胞组织相容性抗原-DR 

分 类 号：R631[医药卫生—外科学]