T细胞免疫功能变化对严重烧伤病人的影响及调节机制  

Adjustment mechanism of changes of T lymphocyte immunity function in severe burn patients

作　　者：李江华[1] 何明武[1] 胡军[1] 姚忠军[1] 

机构地区：[1]郧阳医学院附属太和医院显微整形外科,湖北十堰442000

出　　处：《西部医学》2010年第3期443-446,共4页Medical Journal of West China

摘　　要：目的研究T淋巴细胞免疫功能的变化对严重烧伤病人的影响及机制。方法选择35例严重烧伤病人,分为脓毒症组(20例)和非脓毒症组(15例)。分别于两组患者伤后1d、5d、10d、15d、20d、25d采集外周静脉血分离T淋巴细胞。方法采用放射免疫法检测白细胞介素2、4、6、8(IL-2、IL-4、IL-6、IL-8)、TNF-α的水平,通过流式细胞仪检测CD4+/CD8+T淋巴细胞的百分率及其凋亡率。结果与非脓毒症组比较,脓毒症组患者伤后1d、5d、10d、15d、20d、25dT淋巴细胞的TNF和IL-2、IL-4、IL-6、IL-8的分泌水平均显著升高(P<0.05或P<0.01),两指标呈显著正相关(r=0.78,P<0.01)。伤后1d、5d、10d、15d、20d、25d,脓毒症组患者CD4+/CD8+T淋巴细胞的百分率明显低于非脓毒症组,而其凋亡率呈相反趋势(P<0.05或P<0.01),两指标呈显著负相关(r=-0.73,P<0.05)。结论严重烧伤后,T淋巴细胞免疫功能持续处于抑制状态;T淋巴细胞凋亡参与了脓毒症细胞免疫紊乱的病理生理过程。Objective To observe the immunological function changes and adjustment mechanism of T lymphocyte in severe burn patients. Methods 35 severe burn patients were divided into sepsis group （S, n= 20） and non-sepsis group （NS, n=15）. The peripheral venous blood samples of the patients were collected on 1, 5, 10, 15, 20 and 25 after the burn days （PBD）. RIA methods were used to determine TNF-α. The apoptosis rate was determined by flow cytome- try. Results Compared with that in NS group, the proliferration ability of T lymphocyte and the level of TNF, IL-2, IL- 4, IL-6 and IL-8 were significantly decreased in patients in S group on 1, 5, 10, 15, 20 and 25 PBD（P〈0.05 or P〈0.01）. The inhibition of T lymphocyte proliferation was positively correlated to the low level of IL-6 production in burn patients（r=0.78,P〈0.01）. The percentage of CD4＋ / CD8＋ T lymphoeytes in S group were obviously lower than that in NS group on 1, 5, 10, 15, 20 and 25 PBD, whereas on opposite tendency in the apoptosis rate of CD4＋/CD8＋ T lymphocytes were found at the same time （P〈0. 05 or P〈0.01）. The percentage of CD4＋ / CD8＋ T lymphocytes were negatively correlated to apoptosis rate of T lymphocytes（r=-0. 73,P〈0.05）. Conclusion The immunological function of T lymphocytes in severe burn patients depressed persistently. Apoptosis of T lymphocyte may participate in the pathological process of cell immunological disorder induced by sepsis.

关 键 词：严重烧伤 T淋巴细胞 免疫功能 凋亡 

分 类 号：R644[医药卫生—外科学]