CAJ | 학술논문

目的：探讨CD4＋CD25＋/highCD127low/-和CD14＋HLA-DRlow/-预测急性胰腺炎严重程度的作用。方法流式细胞仪检测AP患者（ acute pancreatitis ， AP）外周血CD4＋CD25＋/high CD127 low/-、CD14＋HLA-DRlow/-、CD64指数的水平，并与C-反应蛋白（CRP）、急性生理学与慢性健康状况评分系统Ⅱ（ APACHEⅡ）评分、CT严重度指数（ CTSI ）进行相关性分析。结果重症胰腺炎、轻型胰腺炎组CD4＋CD25＋/high CD127 low/-、CD14＋HLA-DRlow/-、CD64指数均明显高于正常对照组，重症胰腺炎组CD14＋HLA-DRlow/-高于轻型胰腺炎组；动态观察结果显示，轻型胰腺炎组CD4＋CD25＋/high CD127 low/-、CD14＋HLA-DRlow/-、CD64指数、CRP均先升高后明显回落；而重症胰腺炎组却持续升高；相关性分析显示，CD14＋HLA-DRlow/-与 CD64指数、CRP、APACHEⅡ、CTSI 成明显正相关。结论 CD14＋HLA-DRlow/-与AP严重程度密切相关，可作为疾病严重程度的指标。
목적：탐토CD4＋CD25＋/highCD127low/-화CD14＋HLA-DRlow/-예측급성이선염엄중정도적작용。방법류식세포의검측AP환자（ acute pancreatitis ， AP）외주혈CD4＋CD25＋/high CD127 low/-、CD14＋HLA-DRlow/-、CD64지수적수평，병여C-반응단백（CRP）、급성생이학여만성건강상황평분계통Ⅱ（ APACHEⅡ）평분、CT엄중도지수（ CTSI ）진행상관성분석。결과중증이선염、경형이선염조CD4＋CD25＋/high CD127 low/-、CD14＋HLA-DRlow/-、CD64지수균명현고우정상대조조，중증이선염조CD14＋HLA-DRlow/-고우경형이선염조；동태관찰결과현시，경형이선염조CD4＋CD25＋/high CD127 low/-、CD14＋HLA-DRlow/-、CD64지수、CRP균선승고후명현회락；이중증이선염조각지속승고；상관성분석현시，CD14＋HLA-DRlow/-여 CD64지수、CRP、APACHEⅡ、CTSI 성명현정상관。결론 CD14＋HLA-DRlow/-여AP엄중정도밀절상관，가작위질병엄중정도적지표。
Objective To investigate the prognostic value of CD 4+CD25+/high CD127 low/-and CD14+HLA-DRlow/-for evaluating the severity of acute pancreatitis .Methods The percentages of CD4+CD25+/highCD127low/-and CD14+HLA-DRlow/-and the CD64 index were measured by flow cytometry in pa-tients with acute pancreatitis ( including 43 cases of mild acute pancreatitis and 24 cases of severe acute pan-creatitis).Moreover, the levels of C-reactive protein (CRP), acute physiology and chronic health evaluationⅡ( APACHEⅡ) score and CT severity index ( CTSI ) were detected for a correlation analysis .Results The percentages of CD4+CD25+/highCD127low/-and CD14+HLA-DRlow/-and the CD64 index in patients with severe and mild acute pancreatitis were significantly higher than those in healthy subjects .Patients with se-vere acute pancreatitis showed higher percentages of CD 14+HLA-DRlow/-than patients with mild acute pan-creatitis.With the disease progression, the CD64 index and the levels of CD4+CD25+/highCD127low/-, CD14+HLA-DRlow/-and CRP were significantly dropped after an initial increase in patients with mild acute pancrea -titis, while these indexes were continuously elevated in patients with severe acute pancreatitis .The percent-age of CD14+HLA-DRlow/-was positively correlated with CD64 index, CRP level, APACHEⅡ score and CTSI.Conclusion CD14+HLA-DRlow/-level was closely related to the severity of acute pancreatitis , which could be used as immune parameter for the estimation of the clinical severity of acute pancreatitis .