【摘要】 目的观察重症脓毒症患者的Th17及Treg的表达,探讨其在重症脓毒症免疫功能中的作用。方法选择入住ICU的重症脓毒症患者30例组成重症脓毒症组及健康体检者30例组成对照组。所有重症脓毒症患者在入住ICU第1、3、5天进行采血,同时进行SOFA评分,流式细胞仪分别检测2组人群外周血Th17细胞及Treg的比率,比较2组间差异。分析重症脓毒症组患者Th17细胞及各类Treg表达率与SOFA评分的相关性。结果 1重症脓毒症组入住ICU第1天CD4+CD25+、CD4+CD25high、CD4+CD25+Foxp3+T细胞及Th17细胞表达率与对照组相比明显增高(P<0.05),重症脓毒症组入住ICU第3天CD4+CD25+、CD4+CD25high、CD4+CD25+Foxp3+T细胞及Th17细胞的表达率与对照组相比明显增高(P<0.01),重症脓毒症组入住ICU第5天CD4+CD25+、CD4+CD25high、CD4+CD25+Foxp3+T细胞及Th17细胞的表达率与对照组相比明显增高(P<0.01)。2重症脓毒症患者Th17细胞表达率与SOFA评分正相关(r=0.461,P=0.000);CD4+CD25+、CD4+CD25highT细胞的表达率与SOFA评分无相关性;CD4+CD25+Foxp3+T细胞的表达率与SOFA评分负相关(r=-0.375,P=0.000)。结论重症脓毒症患者Th17细胞、CD4+CD25+、CD4+CD25high及CD4+CD25+Foxp3+T细胞的表达率较正常健康人明显增高,Th17细胞及CD4+CD25+Foxp3+T细胞的表达率与脓毒症的严重程度相关。更多还原

【Abstract】 Objective To observe the expression level of T helper 17 cell( Th17) and regulatory T cells( Tregs) in patients with severe sepsis,and to explore their role in immune function in severe sepsis. Methods 30 patients with severe sepsis in ICU were selectred as experiment group and 30 healthy cases as control group. The blood of all patients with severe sepsis on day 1,3,5 after admission to ICU was collected. The sequential organ failure assessment score( SOFA score) was assessed simultaneously. Flow cytometry were used to detect the circulatory Th17 cells from each group and the expression ratios of CD4+CD25+、CD4+CD25high/ CD4+CD25+Foxp3+T cells in CD4+T cells,and the differences between two groups were compared. The relationship between the expression ratios of Th17 cells and CD4+CD25+,CD4+CD25high,CD4+CD25+Foxp3+T cells and SOFA score in experiment group. Results 1On the first day of ICU stay,the expression ratios of Th17 cells,CD4+CD25+,CD4+CD25high,CD4+CD25+Foxp3+T cells in the experiment group were dramatically increased when compared with those in the the control group( P < 0. 05). On the third day of ICU stay,the expression ratios of Th17 cells,CD4+CD25+,CD4+CD25high,CD4+CD25+Foxp3+T cells in the experiment group were significantly elevated when compared with those in the control group( P < 0. 01). On the fifth day of ICU stay,the expression ratios of Th17 cells,CD4+CD25+,CD4+CD25high,CD4+CD25+Foxp3+T cells in the experiment group were obviously higher than thise in the the control group( P < 0. 01). 2The expression ratio of Th17 cells from patients with severe sepsis was positively correlated to SOFA score( r = 0. 461,P = 0. 000). However,the expression ratios of CD4+CD25+,CD4+CD25highT cells were not associated with SOFA score,and the expression ratio of CD4+CD25+Foxp3+T cells was negatively correlated to SOFA score( r =- 0. 375,P = 0. 000). Conclusion In patients with severe sepsis,the expression ratios of Th17 cells,CD4+CD25+,CD4 + CD25 high,CD4+CD25+Foxp3+T cells are higher than those in healthy people,and the expression ratios of Th17 cells and CD4 + CD25 + Foxp3 + T cells are associated with the severity of sepsis.更多还原