摘要
目的:探讨创伤后多器官功能衰竭(MOF)患者白细胞流变性和细胞粘附分子(CAMs)水平的变化。方法:采用DXC-300A型核孔膜红细胞变形能力测定仪、JYJ-Ⅲ型体外血栓血小板粘附两用仪、酶联免疫吸附法(ELISA),分别检测了36例创伤后MOF患者、31例创伤患者和35例健康人外周血液白细胞变形能力(LD)、白细胞粘附功能(LAF)、白细胞CD18表达、血浆可溶性细胞间粘附分子-1(sICAM-1)和可溶性血管细胞间粘附分子-1(sVCAM—1)的变化。结果:MOF患者白细胞滤过指数(LFI)、白细胞粘附率(LAR)、白细胞CD180表达、sICAM—1,sVCAM—1均明显增高,与对照组和创伤组比较差异有极显著性(F=68.45-116.20,q=12.161—21、374,P〈0.001),MOF组死亡者各指标变化较存活者更明显(t=6.920—11.665,P〈0,001)。MOF患者LFI和LAR与sICAM—1,sVCAM—1和白细胞CD18表达呈正相关(r=0.691~0.844,P〈0.001),LFI与LAR呈正相关(r=0.771,P〈0.001)。结论:白细胞流变性和CAMs水平异常参与了MOF的发生,且与病情严重程度有密切关系。
Objective: To explore the changes of leukocyte rheological cberacteristic and cell adhesion molecule in patients with multiple organ failure(MOF) after severe trauma. Methods: By using the erythrocyte deformability apparatus, platelet and thrombus adhesion dual - purpose apparatus and enzyme- linked immunosorbent assay (ELISA), we measured the leukocyte deformability (LD), leukocyte adhesion funetion(LAF), leukocyte CD18 expression, soluble intercellular adhesion molecule- 1(sICAM- 1) and soluble vascular cell adhesion molecule (sVCAM- 1) concentration in 36 MOF patients, 31 trauma patients, and 35 healthy controls. Results: The leukocyte filtration index(LFI), leukocyte adhesion rate(LAR), leukocyte CD18 expression, and sICAM- 1 and sVCAM- 1 concentration were significantly higher in MOF patients than in controls and trauma patients( F = 68.45 - 116.20, q = 12. 161 - 21. 374, P 〈 0.00 = , and the changes of these indicators in MOF deaths were more obvious than those in MOF survivors( t = 6.920 - 11. 665, P 〈 0.00 = . The LFI and LAR in MOF patients were positively relat- ed to leukocyte CD18 expression, sICAM- 1, and sVCAM- 1 concentration(r= 0.691 - 0.844, P〈 0.001 = ; LFI was positively related to LAB.(r = 0.771, P 〈 0.001 = . Conclusion: The abnormalities of leukocyte rheologic characteristic and CAMs might be closely related to the occurrence of MOF and the severeness of pathologic changes.
出处
《现代生物医学进展》
CAS
2006年第5期30-31,34,共3页
Progress in Modern Biomedicine