脓毒症患者调节性T细胞与CD64指数的相关性研究

目的 探讨CD4+ CD25+/highCD127low/-、CD14+ HLA-DR+在脓毒症发生发展中的作用.方法 流式细胞术检测脓毒症患者(其中生存组17例,死亡组11例)CD4+ CD25+/highCD127low/-、CD14+ HLA-DR+、CD64指数,同时测定白细胞数(WBC)和C-反应蛋白(CRP)的水平,并与正常对照组比较.结果 脓毒症组CD4+ CD25+/highCD127 low/-、CD64指数均明显高于正常对照组,CD14+ HLA-DR+明显低于正常对照组；动态观察结果显示,随着疾病的进展,生存组CD4+ CD25+highCD127low/-、CD64指数均明显回落,而死亡组两者却持续升高；而CD14+ HLA-DR+刚好相反,生存组CD14+HLA-DR+逐渐升高,死亡组CD14+ HLA-DR+明显低于存活组,且持续处于低水平状态；相关性分析显示,CD4+ CD25+/high CD127low/-与CD64指数、CRP正相关；CD14+ HLA-DR+与CD64指数、CRP明显负相关；CD54指数与WBC、CRP正相关.结论 CD4+CD25+/highCD127low/-、CD14+ HLA-DR+与疾病感染和炎症严重程度密切相关,可作为疾病严重程度及预后的指标.

Correlation of tregs and CD64 index in sepsis patients

OBJECTIVE To investigate the effects of CD4+CD25+/highCD127low and CD14+HLA-DR+ on the pathogenic mechanism in sepsis.METHODS CD4+CD25+/highCD127low,CD14+HLA-DR+ and CD64 index were detected by flow cytometry in sepsis patients.At the same time,WBC and CRP were detected respectively.The results were compared with those of normal controls.RESULTS CD4+CD25+/highCD127low and CD64 index were significantly higher in sepsis than those in normal controls.CD14+HLA-DR+ were significantly lower in sepsis than those in normal controls.Dynamic observation showed that CD4+CD25+/highCD127low and CD64 index decreased gradually in survival patients,while improved continuously in dead patients.However,CD14+HLA-DR+ improved gradually in survival patients,while decreased continuously in the low levels in dead patients.Correlation analysis indicated that CD4+CD25+/highCD127low was in positive correlation with CD64 index and CRP,and CD14+HLA-DR+ was in negative correlation with CD64 index and CRP.CD64 index was in positive correlation with WBC and CRP.CONCLUSION CD4+CD25+/highCD127low and CD14+HLA-DR+ are closely related to the severity of infection and diseases,and may be used as immune parameters for the estimation of the clinical severity and the prognosis of acute and severe diseases.