CAJ | 학술논문

目的观察严重多发伤患者伤后外周血调节性T细胞(Treg细胞)的变化及其与脓毒症和损伤严重度的关系. 方法 60例严重多发伤患者按ISS评分排序后分为严重组(30例),危重组(30例);按是否伴发脓毒症分为脓毒症组(22例)和非脓毒症组(38例).于伤后1,3,5,8 d用流式细胞仪检测各组患者外周血Treg细胞的比率. 结果严重多发伤患者伤后5 dTreg细胞比率开始升高,与伤后3 d相比差异有统计学意义(P<0.01);伤后8 d仍持续升高(P<0.05).伤后8 d,危重组外周血Treg细胞比率显著高于严重组(P<0.01),脓毒症组外周血Treg细胞比率显著高于非脓毒症组(P<0.05).Spearman相关分析显示Treg细胞比率与ISS评分呈正相关(rs=0.654,P<0.01). 结论 Treg细胞在严重创伤后的免疫抑制中扮演着重要的角色,Treg细胞比率的变化有助于评估患者的预后及判断并发脓毒症的危险度.
목적 관찰엄중다발상환자상후외주혈조절성T세포(Treg세포)적변화급기여농독증화손상엄중도적관계. 방법 60례엄중다발상환자안ISS평분배서후분위엄중조(30례),위중조(30례);안시부반발농독증분위농독증조(22례)화비농독증조(38례).우상후1,3,5,8 d용류식세포의검측각조환자외주혈Treg세포적비솔. 결과 엄중다발상환자상후5 dTreg세포비솔개시승고,여상후3 d상비차이유통계학의의(P<0.01);상후8 d잉지속승고(P<0.05).상후8 d,위중조외주혈Treg세포비솔현저고우엄중조(P<0.01),농독증조외주혈Treg세포비솔현저고우비농독증조(P<0.05).Spearman상관분석현시Treg세포비솔여ISS평분정정상관(rs=0.654,P<0.01). 결론 Treg세포재엄중창상후적면역억제중분연착중요적각색,Treg세포비솔적변화유조우평고환자적예후급판단병발농독증적위험도.
Objective To observe change of T regulatory cells (Tregs) and its relation with in-jury severity and sepsis following severe muhiple injury. Methods A total of 60 patients were em-ployed in the study and divided into severe group (30 patients) and critical group (30 patients) based on ISS scores and into sepsis group (22 patients) and non-sepsis group (38 patients) based on complication of sepsis. The proportion of Tregs in peripheral blood in different groups was detected by flow cytometry at days 1,3,5 and 8 after injury. Results The proportion of Tregs was significantly increased at day 5 postinjury, with statistical difference compared with that at day 3 postinjury (P < 0.01). The proportion of Tregs remained increasing at day 8 pestinjury (P < 0.05). At day 8 postinjury, the proportion of Tregs in critical group was significantly higher than that in severe group (P < 0.01). At the same time, the proportion of Tregs in sepsis group was significantly higher than that in non-sepsis group (P < 0.05). Spearman correlation analysis showed a positive correlation of Tregs proportion with ISS score (rs =0.654, P < 0.01). Conclusions Tregs play an important role in suppression of T cell-mediated im-munity after severe injury. The variation of Tregs can help evaluate prognosis and predict the risk of com-plicating sepsis in patients with severe multiple injury.