CAJ | 학술논문

目的：探讨严重创伤后患者血液中NK细胞的动态变化与发生并发症的关系。方法42例严重创伤患者于入院当时及伤后1、3、7 d抽血检测外周血中NK细胞，并监测心、肺、肝、肾等脏器功能；分析NK细胞在多脏器功能衰竭（ MODS）组、炎症反应综合征组（ SIRS）、无并发症组（ Un）各组中的变化规律。结果①创伤后当天NK细胞在MODS组与SIRS组均高于健康对照组；MODS组在创伤后1、3、7 d NK细胞高于健康对照组；SIRS组在创伤后1、3 d NK细胞仍高于健康对照组；Un组NK细胞在伤后0 d略有升高，在1 d即恢复至正常水平。②MODS组在创伤后NK细胞始终高于Un组；SIRS组NK细胞仅在伤后当天高于Un组。结论严重创伤后不同并发症患者外周血中NK细胞的变化并不相同，动态监测免疫功能的变化情况可对创伤后并发症的发生有一定的预警作用，应根据免疫细胞的变化情况制订治疗方案。
목적：탐토엄중창상후환자혈액중NK세포적동태변화여발생병발증적관계。방법42례엄중창상환자우입원당시급상후1、3、7 d추혈검측외주혈중NK세포，병감측심、폐、간、신등장기공능；분석NK세포재다장기공능쇠갈（ MODS）조、염증반응종합정조（ SIRS）、무병발증조（ Un）각조중적변화규률。결과①창상후당천NK세포재MODS조여SIRS조균고우건강대조조；MODS조재창상후1、3、7 d NK세포고우건강대조조；SIRS조재창상후1、3 d NK세포잉고우건강대조조；Un조NK세포재상후0 d략유승고，재1 d즉회복지정상수평。②MODS조재창상후NK세포시종고우Un조；SIRS조NK세포부재상후당천고우Un조。결론엄중창상후불동병발증환자외주혈중NK세포적변화병불상동，동태감측면역공능적변화정황가대창상후병발증적발생유일정적예경작용，응근거면역세포적변화정황제정치료방안。
Objective To investigate the relationship between the dynamic variation of NK cells and the severe complications in patients with major trauma .Methods According to ISS scores , 42 patients with major trauma were enrolled .At admission and 1, 3, 7 days after injury, peripheral blood were sampled to detect NK cells, and the pulmonary, hepatic, renal and cardiac function were evaluated.Furthermore, the variation of NK cells in the multiple organ dysfunction syndrome ( MODS) group, the inflammatory response syndrome ( SIRS) group and the uncomplicated ( Un) group were analyzed statistically .Results ①Compared with the normal control group , NK cells in the MODS and SIRS groups significantly increased at admission .Compared with the normal control group , NK cells in MODS group significantly increased 1, 3 and 7 days after trauma.Compared with the normal control group, NK cells in the SIRS group significantly increased 1 and 3 days after trauma .NK cells in the Un group recovered to normal level 1 day after trauma .②Compared with the Un group , NK cells significantly increased in the MODS group after trauma .However , NK cells in the SIRS group were higher than that of the Un group only at admission .Conclusion The variation of NK cells are different in different complications after major trauma .Therefore, dynamical monitoring the variation of immune cells maybe play a predictive role for complications after major trauma .Furthermore, the strategy of immune modulating therapies for major trauma should be based on changes of immune cells .