脓毒症患者CD4~+CD25~+调节性T细胞检测的临床意义

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。

Clinic significance of Testing CD4+CD25+ Treg cells in patients with sepsis

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=15),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.