HLA-DR/CD14在外周血单核细胞中的表达及其临床意义  

Expression of HLA-DR/CD14 on peripheral blood mononuclear cells and its clinical significance

作　　者：李薇[1] 谢闻悦[1] 张卫云[1] 张璇[1] 张玉新[2] 高贵阳[1] 

机构地区：[1]广州军区广州总医院检验科,广州510010 [2]广州军区广州总医院普通外科,广州510010

出　　处：《解放军医学杂志》2011年第1期61-63,共3页Medical Journal of Chinese People's Liberation Army

基　　金：国家高技术研究发展计划(863计划)课题(2008AA022503)

摘　　要：目的探讨外周血单核细胞表面HLA-DR/CD14的表达率及其临床意义。方法收集2008年4月-2009年4月的住院患者140例,其中ICU急重症疾病组101例,其他疾病组39例,以同期20名健康体检者为正常对照组,应用流式细胞术检测各组外周血单核细胞表面HLA-DR/CD14表达率,并测定急重症疾病组C反应蛋白(CRP)水平,分析CRP与HLA-DR/CD14表达率的关系。在急重症疾病组中选择15例患者,分别于急诊入院后的第1、4、8、12、16、20天取外周血,动态观察HLA-DR/CD14表达率的变化及其与病程发展、临床症状的关系。结果急重症疾病组HLA-DR/CD14表达率(38.64%±14.15%)显著低于其他疾病组(56.04%±21.01%,P<0.05)及正常对照组(76.33%±7.82%,P<0.01),且其他疾病组显著低于正常对照组(P<0.05)。相关分析显示,急重症疾病组HLA-DR/CD14表达率与CRP水平呈负相关(r=-0.704,P<0.01)。对急重症疾病组15例患者进行动态观察显示:其中6例死亡患者HLA-DR/CD14表达率随病程进展呈持续下降状态,始终未能纠正,直至死亡;另外9例存活患者随病程好转,HLA-DR/CD14表达率逐渐上升至正常水平,临床症状也随之明显改善直至治愈。结论外周血单核细胞表面HLA-DR/CD14表达率与感染及疾病的严重程度密切相关,可作为判断急重症疾病严重程度和预后的免疫指标。Objective To investigate the HLA-DR/CD14 expression on the surface of peripheral blood mononuclear cell and its clinical significance.Methods One hundred and forty patients hospitalized from Apr.2008 to Apr.2009 were involved in present study,including 101 of acute and severe cases and 39 other cases,while 20 persons undergoing health examination were involved as control.The expression rate of HLA-DR/CD14 on peripheral blood mononuclear cells was detected by flow cytometry,and the serum level of C-reactive protein（CRP） in acute and severe group was determined,and the correlation between HLA-DR/CD14 expression rate and CRP level was analyzed.Meanwhile,15 cases were selected from acute and severe group,the expression rate of HLA-DR/CD14 on peripheral blood mononuclear cells at 1,4,8,12,16 and 20 days after emergency hospitalization was determined and its relation to disease courses and clinical symptoms was dynamically observed.Results The expression rate of HLA-DR/CD14 was markedly lower in acute and severe group（38.64%±14.15%） than in other disease group（56.04%±21.01%,P〈0.05） and control group（76.33%±7.82%,P〈0.01）,and in other diseases group than in control group（P〈0.05）.Correlation analysis indicated that a negative correlation existed between the expression rate of HLA-DR/CD14 and serum CRP level in acute and severe group（r=-0.704,P〈0.01）.Dynamic observation of 15 patients in acute and severe group showed：the expression rate of HLA-DR/CD14 decreased continuously without amelioration in 6 died patients till their death;while was improved gradually to normal level with symptom improving in other 9 survival patients till their recovery.Conclusion The expression rate of HLA-DR/CD14 on peripheral blood mononuclear cells is closely related to the severity of infection and disease,and may be used as an immune parameter to estimate the clinical severity and prognosis of acute and severe diseases.

关 键 词：流式细胞术 抗原 CDL4 HLA-DR抗原 感染 

分 类 号：R446.11[医药卫生—诊断学] R631[医药卫生—临床医学]