严重创伤感染患者mHLA-DR表达率变化及意义  

Changes and Significance of mHLA-DR Expression Rate in Patients with Severe Trauma Infection

作　　者：胡蝶[1] 刘艳杰[1] HU Die;LIU Yanjie(Department of Clinical Laboratory,Wujin Hospital Affiliated to Jiangsu University(Wujin Clinical College of Xuzhou Medical University),Changzhou,Jiangsu Province,213017 China)

机构地区：[1]江苏大学附属武进医院(徐州医科大学武进临床学院)检验科,江苏常州213017

出　　处：《系统医学》2023年第18期5-8,12,共5页Systems Medicine

摘　　要：目的分析单核细胞人类白细胞抗原-DR(monocyte human leukocyte antigen-DR,mHLA-DR)表达率的变化在严重创伤继发感染患者的发生、发展以及转归的临床意义。方法选取2019年1月—2022年12月江苏大学附属武进医院收治的88例严重创伤患者作为研究对象,根据观察期内感染情况分为全身感染组33例、局部感染组30例和非感染组25例3组,采用流式细胞术检测患者第1、3、5、7天外周血mHLA-DR表达率。结果全身感染组第7天mHLA-DR表达率(32.79±13.24)%低于第1天(51.41±15.65)%,差异有统计学意义(P<0.05);局部感染组第7天与第1天比较,差异无统计学意义(P>0.05);非感染组第7天mHLA-DR表达率(69.35±9.42)%高于第1天(58.07±11.25)%,差异有统计学意义(P<0.05)。创伤患者mHLA-DR表达率在第5和7天各感染组间比较,差异有统计学意义(P<0.05)。全身感染死亡组第7天与第1、3天mHLA-DR表达率差值分别为(24.61±8.14)%和(12.70±6.24)%,高于生存组,差异有统计学意义(P<0.05)。结论连续动态监测严重创伤感染患者mHLA-DR的表达变化,可能对了解患者病情变化、评估免疫状态以及预后有临床价值。Objective To analyze the clinical significance of changes in the expression rate of monocyte human leukocyte antigen-DR(mHLA-DR)in the occurrence,development and outcome of patients with secondary infection after severe trauma.Methods A total of eighty-eight patients with severe trauma admitted to Wujin Hospital Affiliated to Jiangsu University from January 2019 to December 2022 were selected as the research subjects,and divided into three groups according to the infection status during the observation period:systemic infection group(33 cases),local infection group(30 cases)and non-infection group(25 cases).The expression rate of mHLA-DR in peripheral blood of patients at day 1st,3rd,5th,7th was detected by flow cytometry.Results The expression rate of mHLA-DR in the systemic infection group was(32.79±13.24)%on day 7,lower than that on day 1(51.41±15.65)%,and the difference was statistically significant(P<0.05).There was no statistically significant difference between the local infection group on day 7 and day 1(P>0.05).The expression rate of mHLA-DR in the non-infection group was(69.35±9.42)%on day 7 compared with day 1(58.07±11.25)%,and the difference was statistically significant(P<0.05).The expression rate of mHLA-DR in trauma patients began to differ between the infected groups at day 5 and 7,and the difference was statistically significant(P<0.05).The difference of mHLA-DR expression rate between the death group on day 7 and day 1 and day 3 was(24.61±8.14)%and(12.70±6.24)%,respectively,which was higher than that of the survival group,and the difference was statistically significant(P<0.05).Conclusion Continuous and dynamic monitoring of mHLADR expression in patients with severe trauma infection may be of clinical value in understanding the disease changes,evaluating immune status and prognosis of patients.

关 键 词：单核细胞 人类白细胞抗原-DR 创伤 感染 流式细胞术 动态变化 

分 类 号：R392.33[医药卫生—免疫学]