CD14阳性单核细胞HLA-DR表达率在老年重症肺炎患者中的临床意义  

Clinical Significance of HLA-DR Expression on CD14^+ Monocyte in Elderly Patients with Severe Pneumonia

作　　者：胡英芳[1] 王灿敏[1] 宋云峰[1] 魏宜 

机构地区：[1]广东省第二人民医院重症医学科,广东广州510310

出　　处：《临床医学工程》2017年第1期26-27,共2页Clinical Medicine & Engineering

基　　金：广东省中医药局基金项目(20160426)

摘　　要：目的探讨老年重症肺炎患者HLA-DR CD14^+%与重症肺炎的预后关系。方法选取我院重症医学科2015年7月至2016年6月收治的老年重症肺炎患者49例,分为存活组(29例)和死亡组(20例)。以入院28天生存率为终点,分析患者入院后第1、7天的APACHE-Ⅱ评分和HLA-DR CD14^+%的变化。结果两组患者的入院情况比较差异无统计学意义(P>0.05)。第7天,存活组的HLA-DR CD14^+%出现升高,APACHE-Ⅱ出现下降(P均<0.05);而死亡组的HLA-DR CD14^+%出现下降且低于存活组,APECHE-Ⅱ出现升高且高于存活组(P均<0.05)。结论老年重症肺炎患APACHE-Ⅱ评分动态升高及HLA-DR CD14^+%动态下降提示愈后不良,HLA-DR CD14^+%与APACHE-Ⅱ评分存在负相关。Objective To explore the relation between HLA-DR CD14＋% and prognosis of elderly patients with server pneumonia.Methods 49 cases of elderly patients with server pneumonia admitted to the Intensive Care Unit in our hospital from July 2015 to June 2016were selected and divided into survival group （29 cases） and death group （20 cases）. Taking the survival rate of patients within 28 days afteradmission as the end point, the changes of APACHE- II score and HLA-DR CD14＋% on the first and seventh day after admission wereanalyzed. Results No statistical difference was found in the admission conditions of patients between the two groups （P 〉0.05）. On theseventh day, HLA-DR CD14＋% of the survival group increased and APACHE- II score decreased （both P〈O.05）. HLA-DR CD14＋% of thedeath group decreased, lower than that of the survival group and APACHE- II score increased, higher than that of the survival group （all P〈O.05）.Conclusions Dynamic increase of APACHE- II score and dynamic decrease of HLA-DR CD 14＋% present bad prognosis of elderlypatients with server pneumonia. APACHE- II score has negative correlation with HLA-DR CD14＋%.

关 键 词：重症肺炎 HLA-DR APACHE-Ⅱ评分 免疫 

分 类 号：R563.1[医药卫生—呼吸系统]