脓毒症患者血清高迁移率族蛋白B1对调节性T细胞免疫功能的影响  

Effect of high mobility group protein B1 on the immune function of regulatory T cells

作　　者：安曙光[1] 覃炳军[1] 卢广轩 范彦琦[1] 贾伯康 AN Shuguang;QIN Bingjun;LU Guangxuan;FAN Yanqi;JIA Bokang(ICU,Dongguan People′s Hospital of Guangdong,Dongguan 523000,China)

机构地区：[1]广东省东莞市人民医院ICU,广东东莞523000

出　　处：《实用医学杂志》2018年第17期2912-2915,共4页The Journal of Practical Medicine

摘　　要：目的探讨脓毒症患者血清高迁移率族蛋白B1对调节性T细胞免疫功能的影响。方法收集2015年1月到2017年5月于ICU科治疗的80例脓毒症患者的患者静脉血样,80例患者中37例脓毒症患者,43例严重脓毒症患者(其中休克患者有11例)。收集患者的外周静脉血,采取酶联免疫吸附试验对患者的血清高迁移率族蛋白B1水平进行检测;对患者外周血T淋巴细胞增殖水平和白细胞介素-2(IL-2)表达水平进行检测,并采用流式细胞仪对CD4+/CD8+T细胞的比值进行检测,并按照脓毒症患者的预后情况,进一步将脓毒症患者分为死亡组与存活组,其中死亡组23例,采集血标本(统计存活21 d内),存活组57例,对患者存活与死亡患者中的血清HMGBl水平进行比较。结果脓毒症患者的血清高迁移率族蛋白B1水平明显升高,且随着病情的严重其HMGBl水平也随之升高,脓毒症患者HMGBl水平明显高于正常组,差异具有统计学意义(P <0.05),脓毒症患者与正常组比较,其外周血T淋巴细胞增殖反应和IL-2的表达水平、CD4+/CD8+T淋巴细胞比值显著低于正常组,差异均具有统计学意义(均P <0.05),且脓毒症患者死亡组血清HMGBl表达水平显著高于存活组,差异均具有统计学意义(均P <0.05)。结论脓毒症病人T淋巴细胞免疫功能异常与病人的脓毒症严重程度具有直接关系,脓毒症病人血清高迁移率族蛋白B1水平的提升对机体细胞免疫功能紊乱存在明显的影响。Objective To investigate the effect of high mobility group protein B1 on the immune function of regulatory T cells.Methods From January 2015 to May 2017,80 patients with sepsis were treated with venous blood samples,37 cases of sepsis and 43 patients with severe sepsis(of which 11 were shock patients)in the ICU department of our hospital.Peripheral venous blood samples were collected,and serum high mobility group box-1 protein B1 level was detected by enzyme-linked immunosorbent assay.Proliferation of the peripheral blood T lymphocyte and interleukin-2(IL-2)level were determined.The ratio of CD4^+/CD8^+T cells was detected by flow cytometry.In accordaning with the prognosis of patients with sepsis,the sepsis patients were further divided into the death group and the survival group,with 23 patients in the death group(blood samples were collected within 21 days)and 57 patients in the survival group.The serum HMGBl level of patients was compared between two groups.Results The level of serum HMGBl in patients with sepsis was significantly increased in accordance with the severity of sepsis.The level of serum HMGBl in sepsis patients was significantly higher than that of healthy control people(P<0.05).Compared with the normal group,the peripheral blood T lymphocyte proliferation,the expression of IL-2 and CD4+CD8+T/lymphocyte ratio were significantly lowered in the sepsis patients(P<0.05).The level of serum HMGBl patients with sepsis was significantly higher than that of patients in the survival group(P<0.05).Conclusion The immune function abnormality of T lymphocyte of sepsis patients is directly related to the severity of sepsis.The elevation of serum HMGBl level in sepsis patients has a significant effect on cellular immune dysfunction.

关 键 词：脓毒症 血清高迁移率族蛋白B1 免疫 预后 

分 类 号：R459.7[医药卫生—急诊医学]