摘要
目的探讨蝮蛇咬伤患者T淋巴细胞亚群、程序性死亡因子-1(PD-1)的表达变化及在评估病情严重程度与预后中的价值。方法2016年3月至2019年8月蝮蛇咬伤患者106例,根据蛇咬伤严重度评分表(SSS评分)分为轻度组75例与中重度组31例;其中中重度组中有23例患者经治疗康复后14 d随访复查。选择同期本院体检中心体检者30例作为对照组。流式细胞术检测T淋巴细胞亚群和PD-1表达水平;免疫比浊法检测免疫球蛋白、CRP、SAA;流式荧光法测定IL-10、IL-6、TNF-α。结果蝮蛇咬伤患者外周血中炎症指标CRP、SAA、IL-10、IL-6、TNF-α均高于对照组,中重度组高于轻度组,且治疗后降低,差异均有统计学意义(P<0.05)。中重度咬伤组中CD4^(+)T淋巴细胞、CD4^(+)/CD8^(+)值均低于对照组及轻度组,治疗后升高,差异均有统计学意义(P<0.05)。中重度咬伤组CD4^(+)PD-1^(+)和CD8^(+)PD-1^(+)高于轻度组和对照组,治疗后明显降低,差异有统计学意义(P<0.05)。SSS评分与CD4^(+)PD-1^(+)、CRP、SAA、IL-10、IL-6、TNF-α水平呈正相关,与CD4^(+)/CD8^(+)值呈负相关(P<0.05)。结论蝮蛇咬伤后炎症因子、T淋巴细胞亚群及PD-1表达变化明显且与病情严重程度相关,可以作为疾病严重程度与治疗效果的观察指标。
Objective To investigate the expression changes of programmed death factor-1(PD-1)and T lymphocyte subsets in patients with pit viper bites and their value in evaluating the severity and prognosis of the condition.Methods A total of 106 pit viper bite patients treated in People's Hospital of Zhuji City,Zhejiang Province from March 2016 to August 2019 were coUected.According to the snake bite severity rating scale(SSS score),75 patients were divided into mild pit viper bite group and 31 patients were divided into moderate severe pit viper bite group.Among them,23 patients in the moderate and severe group were followed up 14 days after rehabilitation.A total of 30 subjects from the physical examination center of our hospital were selected as control group.T lymphocyte subsets and PD-1 were detected by flow cytometry.Immunoglobulin,CRP and SAA were detected by turbidimetric immunoassay.IL-10,IL-6 and TNF-α were determined by flow fluorometry.Results The inflammatory indexes CRP,SAA,IL-10,IL-6 and TNF-α in peripheral blood of patients with pit viper bite were higher than those in control group(P<0.05),and those in moderate and severe bite group were higher than those in mild bite group,and decreased after treatment,with statistical difference(P<0.05).The value of CD4^(+)T lymphocytes and CD4^(+)/CD8^(+)n moderate and severe bite group were lower than those in control group and mild bite group,and increased after treatment,with statistical difFerences(P<0.05).The value of CD4^(+)PD-1^(+)and CD8^(+)PD-1^(+)in moderate and severe bite group were higher than those in mild bite group and normal control group,and decreased significantly after treatment,with statistical difference(P<0.05).SSS score was positively correlated with the levels of CD4^(+)PD-1^(+),CRP,SAA,IL-10,IL-6 and TNF-α,and negatively correlated with CD4^(+)/CD8^(+).Conclusion The expressions of inflammatory factors,T lymphocyte subsets and PD-1 are significantly changed after pit viper bites and are correlated with the severity of disease,which could be
出处
《浙江临床医学》
2022年第3期344-346,349,共4页
Zhejiang Clinical Medical Journal
基金
绍兴市卫生计生科技计划项目(2016QN14)。
