CAJ | 학술논문

目的：探讨脓毒症患者CD4+CD25+调节性T细胞(Treg)的水平与细胞免疫的关系。方法以2013年7月~2014年6月浙江省温岭市第一人民医院收治的脓毒症患者53例为观察组。将观察组患者按病情分为脓毒症组(18例)、严重脓毒症组(21例)、脓毒症休克组(14例)；按28 d预后情况分为死亡组(16例)和存活组(37例)。另选取25名健康者为对照组。用流式细胞仪检测CD4+CD25+Treg及T细胞亚群水平并进行组间比较。结果 CD4+CD25+Treg表达率院脓毒症休克组跃严重脓毒症组跃脓毒症组跃对照组，各组间差异有统计学意义(P<0.05)。CD3+、CD4+和CD4+/CD8+水平院脓毒症组跃对照组跃严重脓毒症组跃脓毒症休克组，各组间差异有统计学意义(P<0.05)。CD8+水平各组间差异无统计学意义(P跃0.05)。死亡组CD4+CD25+Treg表达率明显高于存活组(P<0.05)；CD3+、CD4+、CD4+/CD8+水平明显低于存活组(P<0.05)；CD8+水平两组间差异无统计学意义(P跃0.05)。结论脓毒症患者Treg细胞水平增高，可能导致T淋巴细胞亚群水平降低，在预测患者预后方面有一定作用。
목적：탐토농독증환자CD4+CD25+조절성T세포(Treg)적수평여세포면역적관계。방법이2013년7월~2014년6월절강성온령시제일인민의원수치적농독증환자53례위관찰조。장관찰조환자안병정분위농독증조(18례)、엄중농독증조(21례)、농독증휴극조(14례)；안28 d예후정황분위사망조(16례)화존활조(37례)。령선취25명건강자위대조조。용류식세포의검측CD4+CD25+Treg급T세포아군수평병진행조간비교。결과 CD4+CD25+Treg표체솔원농독증휴극조약엄중농독증조약농독증조약대조조，각조간차이유통계학의의(P<0.05)。CD3+、CD4+화CD4+/CD8+수평원농독증조약대조조약엄중농독증조약농독증휴극조，각조간차이유통계학의의(P<0.05)。CD8+수평각조간차이무통계학의의(P약0.05)。사망조CD4+CD25+Treg표체솔명현고우존활조(P<0.05)；CD3+、CD4+、CD4+/CD8+수평명현저우존활조(P<0.05)；CD8+수평량조간차이무통계학의의(P약0.05)。결론농독증환자Treg세포수평증고，가능도치T림파세포아군수평강저，재예측환자예후방면유일정작용。
Objective To investigate the relationship between level of CD4+CD25+Treg cells and cell immune state in patients with sepsis. Methods 53 patients with sepsis treated in the First People's Hospital of Wenling City from July 2013 to June 2014 were selected as observation group. The observation group was divided into sepsis group (18 cases), severe sepsis group (21 cases), and septic shock group (14 cases) according to the disease severity; and divided into death group (16 cases) and survival group (37 cases) according to the treatment result. 25 healthy individuals served as controls. The expression of CD4+CD25+Treg cells and T-lymphocyte subsets was detected by flow cytometry. The ex-pression of CD4+CD25+Treg cells and T-lymphocyte subsets within groups was compared. Results The expression rate of CD4+CD25+Treg cells: septic shock group跃severe sepsis group跃sepsis group跃 control group, with significant differ-ence of those groups (P< 0.05). The level of CD3+, CD4+and CD4+/CD8+: sepsis group跃control group跃severe sepsis group跃septic shock group, with significant difference of those groups (P<0.05). There was no significant difference in CD8+of these groups (P跃 0.05). The expression of CD4+CD25+Treg cells in death group was higher than that in sur-vival group (P<0.05), the levels of CD3+, CD4+and CD4+/CD8+in death group was lower than those in survival group (P<0.05). There was no significant difference in CD8+between death group and survival group (P跃0.05). Conclusion The expression of CD4+CD25+Treg cells increased in patients with sepsis, which maybe reduce the levels of T lympho-cyte subsets and has clinical value to assess the prognosis.