摘要
目的探究重症急性胰腺炎(SAP)继发感染患者外周血单核细胞表面人类白细胞抗原DR/CD14+T淋巴细胞(HLA-DR/CD14+)的表达变化。方法选取2018年1月-2019年1月华中科技大学同济医学院附属武汉中心医院收治的重症急性胰腺炎患者80例,根据有无继发感染,将患者分为SAP继发感染组(33例)和SAP非感染组(47例);另选择同期健康体检者30名作为健康对照组。采集入组研究对象空腹静脉血,检测单核细胞表面HLA-DR/CD14+的表达情况;采用细胞表面抗原标记法检测Th1、Th2细胞比例;采用酶联免疫反应(ELISA)法检测血清细胞因子白介素-6(Interleukin-6,IL-6)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)水平。结果 SAP继发感染组外周血单核细胞表面HLA-DR/CD14+表达<30%患者例数显著高于SAP非感染组(P<0.05);SAP继发感染组和SAP非感染组患者外周血单核细胞表面HLA-DR/CD14+表达水平低于对照组(P<0.05),随着治疗的进行,SAP继发感染组和SAP非感染组的外周血单核细胞表面HLA-DR/CD14+表达水平均上升(P<0.05);SAP继发感染组和SAP非感染组患者Th1/Th2比值均低于对照组(P<0.05),随着治疗的进行,SAP继发感染组和SAP非感染组的Th1/Th2比值均上升(P<0.05);SAP继发感染组和SAP非感染组患者IL-6水平均高于对照组(P<0.05),随着治疗的进行,SAP继发感染组和SAP非感染组患者IL-6水平均下降(P<0.05)。结论重症急性胰腺炎继发感染患者体内存在免疫抑制,动态监测外周血单核细胞表面HLA-DR/CD14+对重症急性胰腺炎患者预后,判断是否继发感染具有重要意义。
OBJECTIVE To explore the change of expression of monocyte cell surface human leucocyte antigen DR/CD14^+T lymphocytes(HLA-DR/CD14^+)in peripheral blood of severe acute pancreatitis(SAP)patients with secondary infection.METHODS A total of 80 SAP patients who were treated in Wuhan Central Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology from Jan 2018 to Jan 2019 were enrolled in the study and divided into the secondary infection group with 33 cases and the non-infection group with 47 cases according to the presence of the secondary infection,meanwhile,30 healthy people who received physical examination were chosen as the control group.The fasting venous blood specimens were collected to detect the expression of monocyte cell surface HLA-DR/CD14^+,the percentages of Th1 and Th2 were detected by using cell surface antigen labeling method,and the levels of serum cytokines interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were detected with the use of enzyme-linked immunosorbent assay(ELISA).RESULTS The number of the patients with the expression of monocyte cell surface HLA-DR/CD14+in peripheral blood was significantly larger in the secondary infection group than in the non-infection group(P<0.05);the level of expression of monocyte cell surface HLA-DR/CD14^+in peripheral blood was significantly higher in the secondary infection group and the non-infection group than in the control group(P<0.05).With the progress of treatment,the level of expression of monocyte cell surface HLA-DR/CD14^+in peripheral blood of the secondary infection group and the non-infection group was significantly elevated(P<0.05).The ratio of Th1 to Th2 of the secondary infection group and the non-infection group was significantly lower than that of the control group(P<0.05);with the progress of treatment,the ratio of Th1 to Th2 of the secondary infection group and the non-infection group was significantly increased(P<0.05).The IL-6 level of the secondary infection group and the non-infection group wa
作者
周珊珊
陈婷
张婷
田甜
李谆
ZHOU Shan-shan;CHEN Ting;ZHANG Ting;TIAN Tian;LI Zhun(Wuhan Central Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2020年第17期2661-2665,共5页
Chinese Journal of Nosocomiology
基金
湖北省科研基金资助项目(2018121)。
