急性胰腺炎患者外周血髓源性抑制细胞表达膜型B7-H3的临床意义  

Clinical significance of B7-H3, an expression membrane type of myeloid-derived suppressor cell in patients with acute pancreatitis

作　　者：孙正杰[1] 黄坚[1] 武正旺 吴文庆 沈佳庆[2] 张光波[3] Sun Zhengjie Huang Jian Wu Zhengwang Wu Wenqing Shen Jiaqing Zhang Guangbo(Department of Emergency , Department of Gastroenterology , The Laboratory of Clinical Immunology , the First Hospital Affiliated to Soochow University, Suzhou 215006, China Department of General Surgery, Changzhou No 7 People＇s Hospital, Changzhou 213000, China Department of General Surgery, Suzhou Wuzhong District People＇s Hospital, Suzhou 215128, China)

机构地区：[1]苏州大学附属第一医院急诊内科,苏州215006 [2]苏州大学附属第一医院消化内科,苏州215006 [3]苏州大学附属第一医院免疫学实验室,苏州215006 [4]常州市第七人民医院普外科,常州213000 [5]苏州市吴中区人民医院普外科,苏州215128

出　　处：《中华急诊医学杂志》2017年第11期1290-1295,共6页Chinese Journal of Emergency Medicine

基　　金：苏州市科技局基金（SYS201537,SYSD2015051）;常州市科技局基金（常卫计ZD201507）

摘　　要：目的探讨外周血髓源性抑制细胞（MDSC）以及膜型B7家族同源分子-3（B7-H3）在急性胰腺炎表达的临床意义。方法选择2014年1月至2015年12月间在苏州大学附属第一医院急诊科初诊的急性胰腺炎患者（AP）63例，其中轻度急性胰腺炎（MAP）25例、中度急性胰腺炎（MSAP）20例、重度急性胰腺炎（SAP）18例；对照组为年龄、性别匹配的健康人群组20例。诊断标准符合2013年中国急性胰腺炎诊治指南要求，并除外可能影响结果的其他基础疾病，如肿瘤、自身免疫病、病毒感染以及创伤等。利用流式检测分析外周静脉血MDSC表达比例以及MDSC膜上B7-H3表达情况，并对AP患者进行24、48、72h动态检测。采用完全随机设计重复测量的方差分析。结果AP发病24hMDSC细胞群体较健康对照组明显升高（P〈0．01），SAP组表达最高，MSAP组其次，均高于MAP组，各组两两比较差异有统计学意义（P〈0．05）；各组动态观察：MAP组、MSAP组发病24、48、72hMDSC差异无统计学意义，然而SAP组MDSC48h升至最高，72h下降，差异有统计学意义（P〈0．05）。AP发病24hMDSC模型B7-H3高表达，健康对照组几乎不表达；SAP组表达最高，MSAP组其次，均高于MAP组，各组两两比较差异有统计学意义（P〈0．05）；动态观察MDSC膜型B7-H3表达MAP组、MSAP组发病24、48、72h，膜型B7-H3表达差异无统计学意义，然而SAP组mB7-H3表达24、48、72h呈上升趋势，差异有统计学意义（P〈0．05）。结论MDSC及MDSC膜型B7-H3在急性胰腺炎高表达，而且表达在MAP、MSAP、SAP中差异显著，对AP免疫紊乱的深入认识能更好指导临床实践。Objective To explore the clinical significance of B7 family homology factor-3 （ B7-H3 ） , an expression membrane type of myeloid-derived suppressor cell （ MDSC）, in patients with acute pancreatitis （AP）. Methods A total of 63 patients with AP initially treated in the Emergency Department at the First Affiliated Hospital of Soochow University from January, 2014 to December, 2015 were selected. Of them, 25 suffered from mild AP （MAP）, 20 had moderate AP （MSAP） and 18 had severe AP （SAP）. Another 20 healthy subjects with matching age and gender served as the control group. All patients with AP conformed to the diagnostic criteria of Guidelines or Diagnosis and Treatment of Acute Pancreatitis set in 2013 in China. Patients with other underlying diseases that might influence the clinical outcomes were excluded, including those with tumors, autoimmune diseases, viral infections, trauma and other disorders. A flowcytometer was used to detect the expression rate of MDSC in peripheral venous blood and the expression of B7-H3 on MDSC membrane. The continuous monitoring was carried out for 24 h, 48 h and 72 h in patients with AP. Results Compared with healthy subjects, the MDSC cells in patient groups 24 hours after AP onset increased notably （P 〈 0. 01 ） especially the highest increase in the SAP group, followed by the MSAP group and the lowest in the MAP group. There were significant differences in pairwise comparisons （P 〈 0. 05 ）. From successive observation of each group, there was no significant difference in MDSC between the MAP group and the MSAP group 24 hours, 48 hours and 72 hours after AP onset. However, MDSC reached its peak 48 hours after AP onset, but it declined 72 hours after AP onset in the SAP group （ P 〈 0. 05 ）. B7-H3 expressed significantly 24 hours after AP onset, but there was no expression of B7-H3 in the healthy group. Meanwhile, B7-H3 was expressed most highly in the SAP group, followed by the MSAP group and lowest in the MAP group. There were significant

关 键 词：急性胰腺炎 外周血髓源性抑制细胞 膜型B7家族同源分子-3 

分 类 号：R576[医药卫生—消化系统]