CAJ | 학술논문

目的探讨严重创伤患者外周血中Th17和调节性T细胞(Treg)比例变化及其临床意义. 方法 35例多发伤患者根据治疗期间是否发生脓毒症分为创伤组(22例)和脓毒症组(13例),选择9例健康志愿者设为对照组.采集外周血,流式细胞术检测Th17和Treg比例,实时荧光定量RT-PCR检测RORγt和FoxP3 mRNA表达,ELISA检测血清IL-4、IL-6、IL-10、IL-17A、IL-23、转化生长因子-β(TGF-β)、干扰素-γ(IFN-γ)和C反应蛋白(CRP)水平,分析Th17/Treg比值变化及其临床意义. 结果创伤组Th17比例与对照组差异无统计学意义,Th 17/Treg比值较对照组稍低(P＜0.05)；而脓毒症组外周血Th17比例和Th17/Treg比值显著高于创伤组和对照组(P＜0.01).脓毒症组血清TGF-β、IL-6及IL-23含量均明显高于对照组(P＜0.01)；脓毒症组与创伤组比较血清TGF-β含量差异无统计学意义,而血清IL-6、IL-23含量明显高于创伤组(P＜0.01)；脓毒症组血清IL-17含量明显高于创伤组和对照组(P＜0.01).脓毒症组RORγt mRNA水平表达高于创伤组和对照组(P＜0.01). 结论 Th17/Treg失衡与创伤脓毒症的发生密切相关.
목적 탐토엄중창상환자외주혈중Th17화조절성T세포(Treg)비례변화급기림상의의. 방법 35례다발상환자근거치료기간시부발생농독증분위창상조(22례)화농독증조(13례),선택9례건강지원자설위대조조.채집외주혈,류식세포술검측Th17화Treg비례,실시형광정량RT-PCR검측RORγt화FoxP3 mRNA표체,ELISA검측혈청IL-4、IL-6、IL-10、IL-17A、IL-23、전화생장인자-β(TGF-β)、간우소-γ(IFN-γ)화C반응단백(CRP)수평,분석Th17/Treg비치변화급기림상의의. 결과 창상조Th17비례여대조조차이무통계학의의,Th 17/Treg비치교대조조초저(P＜0.05)；이농독증조외주혈Th17비례화Th17/Treg비치현저고우창상조화대조조(P＜0.01).농독증조혈청TGF-β、IL-6급IL-23함량균명현고우대조조(P＜0.01)；농독증조여창상조비교혈청TGF-β함량차이무통계학의의,이혈청IL-6、IL-23함량명현고우창상조(P＜0.01)；농독증조혈청IL-17함량명현고우창상조화대조조(P＜0.01).농독증조RORγt mRNA수평표체고우창상조화대조조(P＜0.01). 결론 Th17/Treg실형여창상농독증적발생밀절상관.
Objective To investigate changes of Th17/Treg ratio in peripheral blood of patients with traumatic sepsis and discuss the underlying clinical significance.Methods Thrity-five multi-trauma patients enrolled in the study were divided into trauma group (n =22) and sepsis group (n =13 ).Another nine healthy volunteers were designed as the control group.Peripheral blood was collected from all the groups so as to determine the ratios of Th17 and Treg by flow cytometry,detect the mRNA expressions of RORγt and FoxP3 by real time fluorescence quantitative PCR and measure serum levels of IL-4,IL-6,IL-10,IL-17A,IL-23,transforming growth factor-β (TGF-β),interferon-γ (IFN-γ) and C-reaction protein (CRP) by ELISA.Further,the change of Th17/Treg ratio and its clinical significance were analyzed.Results The proportion of Th17 in the trauma group showed no significant difference with that in the control group, whereas the ratio of Th17/Treg was lower than that in the control group (P ＜ 0.05).The proportion of Th17 and ratio of Th17/Treg in the sepsis group were higher than those in the trauma group and control group (P ＜ 0.01 ).Serum concentrations of TGF-β,IL-6 and IL-23 in the sepsis group were all significantly higher than those in the control group ( P ＜ 0.01 ).Serum levels of TGF-β had no significant difference between the sepsis group and the trauma group,while serum concentrations of IL-6 and IL-23 in the sepsis group were higher than those in the trauma group ( P ＜ 0.01 ).Serum level of IL-17A and mRNA expression of RORγt in the sepsis group were higher than those in the trauma and control groups ( both P ＜ 0.01 ).Conclusion Th17/Treg imbalance is closely correlated with the development of sepsis in patients with severe trauma.