脓毒症患者外周血CD14^(+)单核细胞HLA-DR、CD86和T淋巴细胞亚群表达水平的变化及其协同表达研究  

Study on the synergistic expression of CD14^(+) monocytes HLA-DR,CD86 and T lymphocyte subsets in patients with sepsis

作　　者：张盛[1] 唐吉斌[1] 鲁厚清[2] 汪俊 ZHANG Sheng;TANG Jibin;LU Houqing;WANG Jun(Department of Clinical Laboratory,Tongling People′s Hospital,Tongling,Anhui 244000,China;Department of Critical Care Medicine,Tongling People′s Hospital,Tongling,Anhui 244000,China)

机构地区：[1]铜陵市人民医院检验科,安徽铜陵244000 [2]铜陵市人民医院重症医学科,安徽铜陵244000

出　　处：《国际检验医学杂志》2021年第18期2219-2221,2227,共4页International Journal of Laboratory Medicine

基　　金：安徽省铜陵市卫生健康委员会医学科研项目(卫科研〔2019〕5号)。

摘　　要：目的探讨脓毒症患者外周血CD14^(+)单核细胞HLA-DR、CD86和T淋巴细胞亚群表达水平的变化及其协同表达的意义。方法选取2020年1-7月铜陵市人民医院重症医学科收治且确诊的脓毒症患者(脓毒症组)作为研究对象,并以同期入院体检健康者作为对照组。脓毒症组患者入院第1天、第3天及第5天抽取外周静脉血,用流式细胞术分析CD14^(+)单核细胞HLA-DR、CD86^(+)CD14^(+)和T淋巴细胞亚群表达水平,同时检测对照组入院体检当日上述各指标水平并对两组各指标进行分析比较。结果脓毒症组入院第1天患者外周血CD14^(+)单核细胞HLA-DR、CD86^(+)CD14^(+)、总T淋巴细胞、CD4^(+)T淋巴细胞表达水平明显低于对照组,差异均有统计学意义(P<0.05);脓毒症组入院第3天、第5天患者外周血CD14^(+)单核细胞HLA-DR、CD86^(+)CD14^(+)、CD4^(+)T淋巴细胞表达水平明显低于对照组,差异均有统计学意义(P<0.05)。结论脓毒症患者体内存在免疫麻痹,CD14^(+)单核细胞HLA-DR及CD86均可以评估脓毒症患者免疫状况。Objective To investigate the changes in the expression levels of HLA-DR,CD86 and T lymphocyte subsets of peripheral blood monocytes in patients with sepsis and the significance of their cooperative expression.Methods Confirmed sepsis patients(sepsis group)admitted to the critical care medicine department of Tongling People′s Hospital from January to July 2020 were selected as the research objects,and healthy patients admitted to the hospital during the same period were selected as the control group.Peripheral venous blood was collected from the sepsis group on the fist,third and fifth day of admission,and the expression levels of CD14^(+)monocytes HLA-DR,CD86^(+)CD14^(+)and T lymphocyte subsets were analyzed by flow cytometry.At the same time,the above indexes of the control group were detected on the day of admission physical examination,and the indexes of the two groups were analyzed and compared.Results On the first day after admission,the expression levels of CD14^(+)monocytes HLA-DR,CD86^(+)CD14^(+),total T lymphocytes and CD4^(+)T lymphocytes in peripheral blood of sepsis group were significantly lower than those of control group,and the differences were statistically significant(P<0.05).The expression levels of CD14^(+)monocytes HLA-DR,CD86^(+)CD14^(+)and CD4^(+)T lymphocytes in peripheral blood of in sepsis group were significantly lower than those in control group on the third and fifth day after admission,with statistical significance(P<0.05).Conclusion There is immune paralysis in patients with sepsis.CD14^(+)monocytes HLA-DR and CD86 can evaluate the immune status of patients with sepsis.

关 键 词：脓毒症 单核细胞 T淋巴细胞亚群 

分 类 号：R459.7[医药卫生—急诊医学]