脓毒症患者CD4+CD25+调节性T细胞检测的临床意义

摘要

目的 探讨脓毒症患者CD4+CD25+调节性T细胞(Treg)的水平与机体细胞免疫状态的关系及其检测的临床意义.方法 将脓毒症患者40例按照疾病严重程度分为3组:脓毒症组14例,严重脓毒症组15例,脓毒症休克组11例.所有入选的40例脓毒症患者在入选当天行流式细胞术检测血中CD4+CD25+调节性T细胞的比例和CD3+、CD4+、CD8+和CD4+/CD8+水平.比较脓毒症组、严重脓毒症组和脓毒症休克组血中CD4+CD25+调节性T细胞比例变化和CD3+、CD4+、CD8+和CD4+/CD8+水平变化.同时选取20例健康人为对照组.结果 健康对照组CD4+CD25+调节性T细胞表达率脓毒症休克组最高,严重脓毒症组次之,脓毒症组最低,三组间两两比较差异有统计学意义(P＜0.05).脓毒症组CD3+、CD4+和CD4+/CD8+较正常对照组明显升高(P＜0.05),CD8+较正常对照组差异不明显(P＞0.05).严重脓毒症组和脓毒症休克患者CD3+、CD4+、CD4+/CD8+较正常对照组明显降低(P＜0.05),CD8+较正常对照组改变不明显(P＞0.05).结论 脓毒症患者外周血CD4+CD25+调节性T细胞表达增加,可能导致CD3+、CD4+、CD4+/CD8+水平降低,免疫抑制加强.提示CD4+CD25+调节性T细胞在脓毒症的免疫发病机制中可能起着重要作用,对评估患者预后有临床价值.%Objective To study the level and significance of CD4+CD25+ Treg cells and CD3+、 CD4+、 CD8+ cells in peripheral blood of patients with sepsis. Methods 40 patients with sepsis Patients were divided into three groups: sepsis group(n=14), severe sepsis group(n=l5), and septic shock group (n=11).The expression of CD4+CD25+ Treg cells and CD3+、 CD4+、 CD8+ cells of 40 patients on the day 1 was detected by flow cytometry. The comparision in the expression of CD4+CD25+ Treg cells and CD3+、 CD4+、 CD8+ cells within groups was made. Twenty healthy individuals served as controls. Results The expression rate. The expression of CD4+CD25+ Treg cells was the highest in septic shock group(P＜0.05) followed by the severe sepsis group (P＜0.05) and the sepsis group the lowest(P＜0.05).The level of CD3+、 CD4+ and CD4+/CD8+in sepsis group was higher than control group and the level of CD3+、 CD4+ and CD4+/CD8+ in severe sepsis and sepsis shock was lower than control group. Conclusion The expression of CD4+CD25+ Treg cells was increased in sepsis patients and the level of CD3+、 CD4+ and CD4+/CD8+was low in severe sepsis and sepsis shock patients,suggesting that they may play an important role in pathogenesis of sepsis. Blood Treg％ level can reflect the cell immune state of patientswith sepsis and is of clinical value to assess the prognosis.