重症监护室脓毒症患者T细胞比例、干扰素γ、白细胞介素4及CD25水平变化

doi:10.3969/j.issn.1004-583X.2016.01.016

摘要/Abstract

摘要： 目的观察重症监护室(ICU)内早期脓毒症患者体内的免疫T细胞变化。方法研究对象为在2012年6月至2013年12月间天津海滨人民医院ICU内的74例早期脓毒症患者,30例非感染性全身炎症反应综合征患者(SIRS)及44例健康对照。检验了试验对象血液中CD4⁺CD25⁺Foxp³⁺调节性T细胞(Tregs)的比例、血浆中干扰素-γ(IFN-γ)、白细胞介素4(IL-4)及可溶性CD25的水平。结果与对照组相比,早期脓毒症患者血浆IFN-γ和IL-4明显升高(P<0.01),同时IFN-γ/IL-4比值(P<0.01)也明显上升,脓毒症患者和SIRS患者上述指标差异无统计学意义(P>0.05)。早期症患者体内Tregs比例明显高于SIRS和健康对照,利用这一指标能将早期脓毒症和SRIS区分出来。早期脓毒症患者血浆可溶性CD25水平也显著提高,并且其水平与Tregs的比例呈正相关(r=0.391,P=0.004)。结论结果提示Tregs可以作为脓毒症的早期诊断指标,并以此将此类患者与非感染的全身炎症反应患者区分来开。其比例还可用于评估患者的免疫状况并帮助医生制定最佳免疫调节治疗方案。

关键词: 全身炎症反应综合征, 脓毒症, 重症监护

Abstract: Objective To observe the change of CD4⁺CD25⁺regulatory T cells(Tregs) in early-stage sepsis patients of intensive care unit(ICU).Methods The subjects were 74 early-stage sepsis patients in ICU of Tianjin People's Hospital from June 2012 to December 2013,30 patients with systemic inflammatory response syndrome (SIRS) and 44 healthy controls. The percentage of Tregs cells in the blood, the level of plasma interferon-γ(IFN-γ),interleukin-4(IL-4) and soluble CD25 of the early-stage sepsis patients were tested.Results Compared with the control group, the level of plasma IFN-γ and IL-4 in the early-stage sepsis patients increased significantly(P<0.01). The value of IFN-γ/IL-4 was significantly higher in patients with sepsis and SIRS(P<0.01).There were no difference about the indicators between SIRS patients and early-stage sepsis patients (P>0.05). The percentage of Tregs in early-stage sepsis patients was significantly higher than that of SIRS and health control cases(P<0.01). Using the percentage of Tregs could distinguish early-stage sepsis and SRIS. The plasma soluble CD25 levels in patients with early-stage sepsis also improved significantly, and the level was positively correlated with the percentage of Tregs(r=0.391,P=0.004).Conclusion The results suggest that Tregs can be used as an index of early diagnosis of sepsis, and using the percentage of Tregs could distinguish early-stage sepsis and SRIS. The ratio can be used for evaluating immune status in patients and help doctors formulate the best immune adjustment therapy.

Key words: systemic inflammatory response syndrome, sepsis, intensive care

中图分类号:

R631

董宏, 张慧智, 钱秦娟. 重症监护室脓毒症患者T细胞比例、干扰素γ、白细胞介素4及CD25水平变化[J]. 临床荟萃, 2016, 31(1): 63-67.

Dong Hong, Zhang Huizhi,Qian Qinjuan. Change of Tregs cells percentage, interferon-γ, interleukin-4 and CD25 level in sepsis patients of intensive care unit[J]. Clinical Focus, 2016, 31(1): 63-67.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2016.01.016

https://huicui.hebmu.edu.cn/CN/Y2016/V31/I1/63

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