摘要
目的:观察脓毒症患者外周血中CD4+CD2+CD127-调节性T细胞(Treg)及辅助性T细胞17(Th17)的比例,并探讨Treg/Th17失衡在脓毒症发病中的作用。方法:选择2010年1～8月入住我院ICU的脓毒症患者70例,按疾病严重程度分为脓毒症组(34例)、重症脓毒症组(21例)和脓毒症休克组(15例)。第1 d抽取外周血,应用流式细胞术检测不同组别患者外周血中Treg/Th17比例及CD14单核细胞HLA-DR表达率,并探讨Treg/Th17比例与免疫状态及病情严重程度(APACHEⅡ评分)的关系。选取同期健康查体者为对照组(30例)。结果:(1)和对照组相比,各病例组外周血Treg及Th17比例均明显升高(均P<0.01),但升高的程度不同。Th17表达以重症脓毒症组升高最明显,Treg表达以脓毒症休克组升高最明显。(2)Treg/Th17:脓毒症休克组>重症脓毒症组>脓毒症组,各组两两相比均有显著差异(均P<0.01)。脓毒症组Treg/Th17显著低于对照组(P<0.01),脓毒症休克组Treg/Th17显著高于对照组(P<0.01),但重症脓毒症组Treg/Th17与对照组比较无明显差异。(3)CD14单核细胞HLA-DR表达率:脓毒症休克组<重症脓毒症组<脓毒症组<对照组,两两比较均有显著差异(均P<0.01)。(4)Th17比例和APACHEⅡ评分及HLA-DR表达率无相关性;Treg表达率和APACHEⅡ评分正相关(r=0.93,P<0.01),和HLA-DR表达率负相关(r=-0.89,P<0.01);HLA-DR表达率和APACHEⅡ评分负相关(r=-0.91,P<0.01)。结论:(1)脓毒症患者中Treg和Th17比例失调,Treg/Th17的失衡参与脓毒症的发病及进展。(1)Treg表达率可以在一定程度上反映机体病情及免疫状态。
AIM： To investigate the disequilibrium of regulatory T-lymphocytes（Treg） T helper 17 cells（Th17） in sepsis.METHODS： Seventy sepsis patients hospitalized in our ICU during January 2010 to August 2010 were enrolled in the study and divided into sepsis group（n=34）,severe sepsis group（n=21） and septic shock group（n=15） based on the severity.Serum samples were collected from all the patients on the first day.The percentages of Th17 and Treg and HLA-DR expression in CD14 monocytes were determined by flow cytometry.The relationship between ratio of Treg/Th17,and immune state,pathogenetic severity（score of APACHE II） was also investigated.Thirty matched healthy individuals in the hospital for heath examination in the same period of time served as controls.RESULTS： The percentages of Th17 and Treg were significantly higher in all disease groups than those in control group（all P0.01）.The highest percentage of Th17 was observed in severe sepsis group and the highest percentage of Treg was found in septic shock group.The levels of Treg/Th17 ranged as septic shock group severe sepsis group sepsis group and there was significant difference between every 2 groups（all P0.01）.The level of Treg/Th17 was lower in sepsis group and higher in septic shock group than that in control group（P0.01）,and no significant difference between severe sepsis group and control group was observed.The HLA-DR expression levels in CD14 monocytes ranged as septic shock group severe sepsis group sepsis group control group,and there was significant difference between every 2 groups（all P0.01）.The expression of HLA-DR and score of APACHE II showed no correlation with the percentage of Th17.The percentage of Treg showed positive correlation with the score of APACHE II（r=0.93,P0.01） and negative correlation with the expression of HLA-DR（r=-0.89,P0.01）.The HLA-DR expression showed negative correlation with the score of APACHE II（r=-0.91,P0.01）.CONCLUSION： The ratio of Treg to Th17 is abnormal in sepsis patients.The disequilibrium of Treg/Th17 influences the development,of sepsis.To some extent,the level of Treg reflects the pathogenetic conditions and immune state of sepsis patients.
出处
《中国病理生理杂志》
CAS
CSCD
北大核心
2011年第12期2411-2413,2422,共4页
Chinese Journal of Pathophysiology
