脓毒症患者外周血CD3^＋、CD4^＋、CD8^＋T淋巴细胞的凋亡及Bcl-2蛋白表达  

Apoptosis in CD3^＋, CD4^＋, CD8^＋ lymphocytes and Bcl-2 protein expression in patients with sepsis

作　　者：林玲[1] 蔡秀军[2] 潘孔寒[1] 林永俊[1] 陈大方[3] 

机构地区：[1]浙江大学医学院附属邵逸夫医院危重医学科,杭州市310016 [2]浙江大学医学院附属邵逸夫医院普外科,杭州市310016 [3]浙江大学医学院临床医学研究所,杭州市310016

出　　处：《中华麻醉学杂志》2007年第8期738-740,共3页Chinese Journal of Anesthesiology

基　　金：浙江省教育厅科研基金资助项目（20051908）

摘　　要：目的探讨脓毒症患者外周血淋巴细胞凋亡及其与Bcl-2蛋白表达的关系。方法采集44例脓毒症患者（脓毒症组，年龄19～86岁）和25例健康体检者（正常对照组，年龄29～80岁）的外周静脉血5ml，采用流式细胞仪分别检测CD3^＋、CD4^＋、CD8^＋T淋巴细胞凋亡率和Bcl-2蛋白表达。分析细胞凋亡率与Bcl-2蛋白表达的相关性。脓毒症诊断标准参考1991年美国胸科医师协会和美国危重病医学会联席会议制定的诊断标准。结果与正常对照组比较，脓毒症组患者CD3^＋、CD4^＋T淋巴细胞凋亡率升高，Bcl-2蛋白表达下降（P〈0．05），CD8^＋T淋巴细胞凋亡率及其Bcl-2蛋白表达差异均无统计学意义（P〉0．05），CD3^＋、CD4^＋T淋巴细胞凋亡率分别与其Bcl-2蛋白表达呈负相关（r=-0．389，P〈0．05；r=-0．689，P〈0．05）。结论脓毒症患者细胞免疫功能异常可能与Bcl-2蛋白表达下调导致淋巴细胞凋亡增加有关。Objective To investigate apoptosis in peripheral blood lymphocytes （PBLCs） and its relationship with Bcl-2 protein expression in septic patients. Methods Forty-four septic patients aged 19-86 yr were included in this prospective study. The diagnosis of sepsis was made according to the criteria established by American Society of Critical Care Medicine in 1991. In addition 25 healthy blood donors were included as normal control. Flow cytometry was used to detect apoptosis in PBLCs （CD3^＋ , CD4^＋ , CD8^＋ ） as well as Bcl-2 expression. The correlation between apoptosis rate and Bcl-2 expression was examined. Results Apoptosis in CD3^＋ and CD4^＋ was increased in septic patients as compared to the normal control （13.1% ± 3.2% vs 2.8% ± 1.2%; 13.3% ± 3.4% vs 3.1% ± 1.3%）. While Bcl-2 expression in CD3^＋ and CD4^＋ cells was significantly lower in septic patients than in normal controls （21% ± 4% vs 31% ± 8% ; 5.8% ± 1.8% vs 11.3% ± 3.9% ）. The rates of apoptosis in both CD3^＋ and CD4^＋ cells were negatively correlated with Bcl-2 expression （r = -0. 389; r=0. 689）（ P 〈 0. 05）. There were no significant differences in apaptosis and Bcl-2 expression in CD8^＋ cells between septic patients and normal controls. Conclusion The increased lymphocyte apoptosis due to down-regnlation of Bcl-2 expression may be involved in the dysfunction of cellular immunity in septic patients.

关 键 词：脓毒症 细胞凋亡 T淋巴细胞 基因 BCL-2 

分 类 号：R45[医药卫生—治疗学]