脓毒症患儿T细胞亚群和sjTREC基因水平的评估  

Assessment of T cell subsets and sjTREC gene level in the sepsis children

作　　者：曹清[1] 安康[1] 张建[1] 李璧如[1] 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心儿内科,200127

出　　处：《中国小儿急救医学》2011年第4期312-315,共4页Chinese Pediatric Emergency Medicine

摘　　要：目的本研究旨在评价脓毒症患儿T细胞亚群和sjTREC基因水平，为其合理的免疫调节治疗提供理论依据。方法根据感染严重程度将患儿分为脓毒症组（25例）、严重脓毒症组（23例）和正常对照组（50例）。在使用血制品、免疫制剂及营养支持前测定各组患儿T细胞亚群。通过实时荧光定量PCR法分别检测各组患儿sjTREC基因水平变化，利用双标准曲线法对sjTREC基因水平进行绝对定量，检测结果用sjTREC与Ca内参基因拷贝数比值（sjTREC／Ca×2×1ooo）表示，结果应用SPSS16．0软件进行统计学处理。结果严重脓毒症组患儿CD3＋、CD4＋和CD8＋细胞比例明显低于正常对照组（P〈0．01）；严重脓毒症组患儿sjTREC基因水平为173．86±38．37，明显低于脓毒症组（345．15±66．21）和正常对照组（389．42±50．20），差异有统计学意义（P〈0．01）。结论严重脓毒症患儿存在T细胞亚群数量紊乱和胸腺输出功能下降，故在早期进行细胞免疫支持可能会改善临床预后。Objective To evaluate T-lymphocyte subsets and sjTREC gene level in sepsis children and to provide a reasonable theoretical basis for immune regulation. Methods This prospective study was performed on children who were classified as sepsis group （ n = 25 ）, severe sepsis group （ n = 23 ）, and control group （ n = 50）. The T cell subsets were measured before the blood products, immune agents, and nutritional support were administrated. By real-time fluorescence quantitive-PCR method,the sjTREC levels of the patients with sepsis and healthy children were quantitatively detected respectively;then the sjTREC levels were absolutely quantified by two standard curve method. The results were demonstrated by sjTREC and endogenous reference gene （Cct） copies ratio （ sjTREC/Cα× 2 ×1 000） and statistically analyzed by SPSS 16. 0 software. Results The levels of CD3＋ , CD4＋ , and CD8＋ T cells in severe sepsis group were lower than those in control group （P 〈 0. 01 ）. The level of sjTREC of severe sepsis group was 173. 86 ± 38. 37, which was significantly lower than those of sepsis group （ 345. 15 ±66. 21 ） and control group （ 389. 42±50. 20） （P 〈 0. 01 ）. Conclusion Children with severe sepsis have a range of T-lymphocyte subsets disorders and decreased thymic output function,so early immunotherapy can improve clinical outcome.

关 键 词：脓毒症 T细胞亚群 胸腺输出功能 sjTREC基因 

分 类 号：R720.597[医药卫生—急诊医学]