摘要
目的:探讨脓毒症患者外周血中性粒细胞凋亡与病情严重程度、预后的关系及其可能的机理。方法:将30例脓毒症患者根据急性生理学和慢性健康状况评分Ⅱ(APACHEⅡ)评分,分为APACHEⅡ≥12组(n=10)和<12组(n=20);根据预后分为存活组(n=22)和死亡组(n=8)。同时设立正常对照组(n=15)。测定患者外周血中性粒细胞(PMN)凋亡率,检测血清可溶性Fas(sFas)水平,并分析中性粒细胞凋亡率与血清sFas浓度及预后的关系。结果:APACHEⅡ≥12组PMN凋亡率较APACHEⅡ<12组明显下降(P<0.01);与正常对照组相比,APACHEⅡ≥12组及APACHEⅡ<12组PMN凋亡率均明显下降(P<0.01)。APACHEⅡ≥12组血清sFas浓度较APACHEⅡ<12组明显升高(P<0.05);与正常对照组相比,A-PACHEⅡ≥12组及APACHEⅡ<12组血清sFas浓度明显升高(P<0.01)。存活组和死亡组PMN凋亡率差异无统计学意义。PMN凋亡率与血清sFas浓度呈负相关(r=-0.897,P=0.019<0.05)。结论:脓毒症时外周血PMN凋亡率减少,且与脓毒症严重程度相关,脓毒症病情较严重时PMN凋亡率下降更加明显,其机制可能与脓毒症时血清sFas浓度增加有关,脓毒症时PMN凋亡减少可能对脓毒症预后无预示作用。
Objective：To investigate the changes of neutrophils apoptosis in peripheral blood and the serum concentrations of sFas in sepsis, and to observe the relationships between them. Methods：45 cases were divided into two groups： septic patients group（n = 30）, healthy controls（n = 15）. According to APACHE Ⅱ scores, the septic patients were divided into two subgroups： APACHEⅡ〈12 group（n = 20）; APACHE Ⅱ≥12 group（n = 10）. After two weeks,the septic patients were then also divided into survival group （n = 22） and death group in = 8） . Serum levels of sFas were measured by enzyme-linked immunosorbent assay（ELISA）. The relationship was analysed between the apoptosis rate of PMNs and serum levels of sFas, and prognosis. Results：The apoptosis rate of PMNs in APACHE Ⅱ≥ 12 group was significantly decreased compared to APACHE Ⅱ〈12 group（P〈0.01 ） ; Compared to healthy controls, The apoptosis rate in APACHE Ⅱ 〈 12 group and APACHE Ⅱ ≥ 12 group was significantly low（P〈0.01 ）. The serum level of sFas in APACHE Ⅱ≥12 group was significantly elevated compared to APACHE Ⅱ〈12 group （P〈0.01） ; Compared to healthy controls, the serum level of sFas in APACHE Ⅱ〈12 group and APACHE Ⅱ≥12 group was significantly high（P〈0.01 ）. The difference of apoptosis rate between survival group and death group had no significance. Apoptosis rate of PMNs was negatively correlated with serum concentration of sFas（P〈0.05）. Conclusion：PMN apoptosis rate is decreased in sepsis, and is related to the severity. The increased sFas level in septic patients＇ serum may take some part in PMN apoptosis. Maybe PMN apoptosis can＇t predict septic patients prognosis.
出处
《中国临床医学》
北大核心
2008年第5期712-714,共3页
Chinese Journal of Clinical Medicine
关键词
脓毒症
中性粒细胞
凋亡
炎症介质
可溶性FAS
Sepsis
Polymorphonuclear neutrophil
Apoptosis
Inflammatory factors
sFas
