中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2015年
6期
630-634
,共5页
白如雪%杜时雨%段军%陶永康%杨华元
白如雪%杜時雨%段軍%陶永康%楊華元
백여설%두시우%단군%도영강%양화원
胰腺炎,急性坏死性%感染%T淋巴细胞亚群%T淋巴细胞,调节性
胰腺炎,急性壞死性%感染%T淋巴細胞亞群%T淋巴細胞,調節性
이선염,급성배사성%감염%T림파세포아군%T림파세포,조절성
Fancreatitis,necrotizing%Infection%T-lymphocyte subsets%T-lymphocyte,regulatory
目的 探讨Th17/Treg免疫平衡在老年重症急性胰腺炎患者继发性感染中的变化及意义. 方法 选择重症急性胰腺炎合并继发性感染患者(感染组)21例、重症急性胰腺炎患者(非感染组)25例,健康体检者(对照组)20例,比较各组外周血Th17/Treg细胞及相关细胞因子表达水平. 结果 感染组病死率、重症监护病房(ICU)住院天数与非感染组比较[23.8％比4.0％、(11.3±3.4)d比(7.5±2.8)d],差异均有统计学意义(x2=3.949,P=0.047;t=2.890,P=0.045).感染组Th17细胞百分比、Treg细胞百分比、Th17/Treg比值、白介素-6(IL-6)、白介素-17(IL-17)、白介素-23(IL-23)、转化生长因子-β1(TGF-β1)和孤独受体(ROR-γt)mRNA分别为(26.4±1.2)％、(6.7±1.6)％、(4.3±1.0)％、(7.1±0.8)ng/L、(22.9±2.4)ng/L、(15.7±2.1)ng/L、(23.6±2.2)ng/L和0.052±0.014,非感染组分别为(12.8±0.9)％、(4.2±1.3)％、(3.2±1.1)％、(5.3±0.7) ng/L、(15.6±2.8)ng/L、(10.2±1.5)ng/L、(16.3±1.7)ng/L和0.035±0.010,与对照组(3.1±0.8)％、(1.3±0.4)％、(2.4±0.9)％、(0.2±0.1) ng/L、(10.3±1.5)ng/L、(8.3±1.4)ng/L、(11.6±1.1)ng/L和0.004±0.001比较均明显升高(F=15.761、55.745、9.437、102.788、21.038、16.239、36.957、23.924,P=0.555、0.000、0.014、0.000、0.002、0.004、0.000、0.000).感染组IL 10、Foxp3-TmRNA分别为(6.4±1.1) ng/L、(0.005±0.001),非感染组分别为(10.5±2.1)ng/L、(0.020±0.007),与对照组(15.4±2.0)ng/L、(0.032±0.009)比较明显降低(F=18.995、20.608,P=0.003、0.002). 结论 合并继发性感染可加重重症急性胰腺炎患者Th17/Treg免疫失衡,延长ICU住院时间.
目的 探討Th17/Treg免疫平衡在老年重癥急性胰腺炎患者繼髮性感染中的變化及意義. 方法 選擇重癥急性胰腺炎閤併繼髮性感染患者(感染組)21例、重癥急性胰腺炎患者(非感染組)25例,健康體檢者(對照組)20例,比較各組外週血Th17/Treg細胞及相關細胞因子錶達水平. 結果 感染組病死率、重癥鑑護病房(ICU)住院天數與非感染組比較[23.8％比4.0％、(11.3±3.4)d比(7.5±2.8)d],差異均有統計學意義(x2=3.949,P=0.047;t=2.890,P=0.045).感染組Th17細胞百分比、Treg細胞百分比、Th17/Treg比值、白介素-6(IL-6)、白介素-17(IL-17)、白介素-23(IL-23)、轉化生長因子-β1(TGF-β1)和孤獨受體(ROR-γt)mRNA分彆為(26.4±1.2)％、(6.7±1.6)％、(4.3±1.0)％、(7.1±0.8)ng/L、(22.9±2.4)ng/L、(15.7±2.1)ng/L、(23.6±2.2)ng/L和0.052±0.014,非感染組分彆為(12.8±0.9)％、(4.2±1.3)％、(3.2±1.1)％、(5.3±0.7) ng/L、(15.6±2.8)ng/L、(10.2±1.5)ng/L、(16.3±1.7)ng/L和0.035±0.010,與對照組(3.1±0.8)％、(1.3±0.4)％、(2.4±0.9)％、(0.2±0.1) ng/L、(10.3±1.5)ng/L、(8.3±1.4)ng/L、(11.6±1.1)ng/L和0.004±0.001比較均明顯升高(F=15.761、55.745、9.437、102.788、21.038、16.239、36.957、23.924,P=0.555、0.000、0.014、0.000、0.002、0.004、0.000、0.000).感染組IL 10、Foxp3-TmRNA分彆為(6.4±1.1) ng/L、(0.005±0.001),非感染組分彆為(10.5±2.1)ng/L、(0.020±0.007),與對照組(15.4±2.0)ng/L、(0.032±0.009)比較明顯降低(F=18.995、20.608,P=0.003、0.002). 結論 閤併繼髮性感染可加重重癥急性胰腺炎患者Th17/Treg免疫失衡,延長ICU住院時間.
목적 탐토Th17/Treg면역평형재노년중증급성이선염환자계발성감염중적변화급의의. 방법 선택중증급성이선염합병계발성감염환자(감염조)21례、중증급성이선염환자(비감염조)25례,건강체검자(대조조)20례,비교각조외주혈Th17/Treg세포급상관세포인자표체수평. 결과 감염조병사솔、중증감호병방(ICU)주원천수여비감염조비교[23.8％비4.0％、(11.3±3.4)d비(7.5±2.8)d],차이균유통계학의의(x2=3.949,P=0.047;t=2.890,P=0.045).감염조Th17세포백분비、Treg세포백분비、Th17/Treg비치、백개소-6(IL-6)、백개소-17(IL-17)、백개소-23(IL-23)、전화생장인자-β1(TGF-β1)화고독수체(ROR-γt)mRNA분별위(26.4±1.2)％、(6.7±1.6)％、(4.3±1.0)％、(7.1±0.8)ng/L、(22.9±2.4)ng/L、(15.7±2.1)ng/L、(23.6±2.2)ng/L화0.052±0.014,비감염조분별위(12.8±0.9)％、(4.2±1.3)％、(3.2±1.1)％、(5.3±0.7) ng/L、(15.6±2.8)ng/L、(10.2±1.5)ng/L、(16.3±1.7)ng/L화0.035±0.010,여대조조(3.1±0.8)％、(1.3±0.4)％、(2.4±0.9)％、(0.2±0.1) ng/L、(10.3±1.5)ng/L、(8.3±1.4)ng/L、(11.6±1.1)ng/L화0.004±0.001비교균명현승고(F=15.761、55.745、9.437、102.788、21.038、16.239、36.957、23.924,P=0.555、0.000、0.014、0.000、0.002、0.004、0.000、0.000).감염조IL 10、Foxp3-TmRNA분별위(6.4±1.1) ng/L、(0.005±0.001),비감염조분별위(10.5±2.1)ng/L、(0.020±0.007),여대조조(15.4±2.0)ng/L、(0.032±0.009)비교명현강저(F=18.995、20.608,P=0.003、0.002). 결론 합병계발성감염가가중중증급성이선염환자Th17/Treg면역실형,연장ICU주원시간.
Objective To investigate changes and the significance of Th17/Treg immune imbalance in secondary systemic infection in patients with severeacute pancreatitis.Methods We selected 21 patients with severe acute pancreatitis and secondary systemic infection (infection group),25 patients with severe alone (non-infection group),20 healthy cases undergoing annual health checkup (control group) in this study.The expression levels of Th17/Treg cells and related cytokines were compared between groups.Results There were significant differences in mortality rate and duration of ICU stay between infection group and non-infection group [23.8％ vs.4.0％,(11.3±3.4) d vs.(7.5±2.8) d,x2=3.949,t=2.890,P=0.047 and0.045].The percentages of Th17 cell andTreg cell,Th17/Treg ratio,mRNA expressions of IL-6,IL-17,IL-23,TGF-β and orphan receptor γt were higher in infection and non infection groups than in control group [(26.4 ± 1.2) ％,(12.8 ± 0.9)％ vs.(3.1±0.8) ％;(6.7±1.6)％,(4.2±1.3)％ vs.(1.3±0.4)％;(4.3±1.0)％,(3.2±1.1)％ vs.(2.4±0.9)％;(7.1±0.8)ng/L,(5.3±0.7)ng/L vs.(0.2±0.1)ng/L;(22.9±2.4)ng/L,(15.6±2.8)ng/L vs.(10.3± 1.5)ng/L;(15.7±2.1)ng/L,(10.2± 1.5)ng/L vs.(8.3± 1.4)ng/L;(23.6±2.2)ng/L,(16.3±1.7)ng/L vs.(11.6±1.1)ng/L;(0.052±0.014),(0.035± 0.010) vs.(0.004±0.001);F=15.761,55.745,9.437,102.788,21.038,16.239,36.957,23.924,respectively,P=0.555,0.000,0.014,0.000,0.002,0.004,0.000,0.000].The mRNA expressions of IL-10 and Foxp3-T were lower in infection and non-infection groups than in control group [(6.4±1.1)ng/L,(10.5 ± 2.1) ng/L vs.(15.4±2.0)ng/L;(0.005±0.001),(0.020±0.007) vs.(0.032±0.009),F=18.995 and 20.608,P=0.003 and 0.002].Conclusions The secondary infection can aggravate the Th17 / Treg immune imbalance in patients with severe acute pancreatitis,and extend the ICU hospitalization days.
