严重创伤后氧对T细胞功能的影响

目的 探讨严重创伤后病人T淋巴细胞转化活性及CD4 T、CD8 T细胞活性变化,CTLA-4分子水平在严重创伤转归、干预治疗等方面的意义.方法 将133例病人分为创伤对照组46例、高流量吸氧组44例、高压氧组43例,创伤对照组患者入院后给予常规治疗;高流量吸氧组患者辅以5 L/min,120 min/d吸氧治疗;高压氧组患者辅以高压氧治疗(压力2 ATA,60 min/d).于3、7 d时间点,对各组分别进行T淋巴细胞转化活性、T淋巴细胞亚群及CTLA-4分子水平的测定.结果 与创伤对照组比较,高流量吸氧组和高压氧组患者的T淋巴细胞转化活性增高,CD4 T细胞数明显增多(P＜0.01),CD4 /CD8 细胞比值明显增加(P＜0.01),T细胞表面和总CTLA-4分子表达明显降低(P＜0.01);与高流量吸氧组相比,高压氧组患者的T淋巴细胞转化活性增高,CD4 T细胞数明显增多(P＜0.05),CD4 /CD8 细胞比值明显增加(P＜0.01),T细胞表面和总CTLA-4分子表达降低(P＜0.05).结论 氧能够明显提高T淋巴细胞转化活性,使CD4 T细胞增多,CD4 /CD8 细胞比值明显增加,并且明显降低T细胞表面和总CTLA-4分子的表达.

Effects of oxygen on T lymphocyte function after serious trauma

Objective To explore the effects of oxygen on T lymphocyte function and the change of T lymphocyte transformation and CTLA-4 expression after serious trauma.Method One hundred and thirty-three patients with critical trauma were divided into trauma control group(C,treated by normal therapy),high flow oxygen group(B,breathing oxygen 5L/min,120min/d)and hyperbaric oxygenation group(A,treated with 2 ATA 60min/d).The T lymphocyte subsets,T lymphocyte transformation and CTLA-4 expression were detected using immunohistochemistry technique and flow cytometry,respectively.Results The T lymphocyte transformation,the numbers of CD4+T and the ratio of CD4+/CD8+ were increased more significantly in group B and A,while the level of CTLA-4 surface expression was reduced more remarkably,than those in group C(P<0.01).Conclusion Oxygen is effective in promoting T lymphocyte transformation and decreasing the level of CTLA-4 surface expression obviously.