创伤患者外周血CD14-/CD11b+/CD33+髓源抑制细胞数量变化及临床意义

目的 探讨严重创伤患者外周血中髓源抑制细胞(MDSCs)数量变化及其临床意义.方法 收集34例多发伤患者和7例健康志愿者外周血,以CD14-/CD11b+/CD33+作为MDSCs标志物,用流式细胞术(FCM)检测MDSCs所占比例,ELISA检测血清IL-10和C反应蛋白水平,分析MDSCs数量的变化情况及其临床意义. 结果对照组外周血MDSCs占(1.13±0.25)%,感染组多发伤患者伤后1,2,3和7 d外周血MDSCs所占比例分别为(1.20±0.22)%、(6.44±0.35)%、(13.84±2.07)%和(15.60±1.63)%,非感染组患者伤后1,2,3和7 d外周血MDSCs所占比例分别为(1.29±0.30)%、(4.93±0.32)%、(5.15±0.21)%和(3.77±0.34)%.两组2,3和7 d时MDSCs比例差异有统计学意义(P＜0.05).MDSCs比例与ISS、血清IL-10和C反应蛋白水平无相关性. 结论多发伤伤患者外周血MDSCs比例升高与并发感染相关,提示它可能在创伤后免疫功能障碍中起重要作用.

Quantity change and clinical significance of CD14- CD11b+ CD33+ myeloid-derived suppressor cells in patients with multiple injury

Objective To explore the quantity change and significance of CD14-/CD11b+/CD33 + myeloid-derived suppressor cells (MDSCs) in patients with multiple injury. Methods Thirtyfour patients with multiple injury and seven healthy volunteers were enrolled in this study. Peripheral blood was collected and the factors of CD14-/CD1 1 b+/ CD33 + were taken as markers of MDSCs. The percentage of MDSCs was determined by flow cytometry (FCM) and serum interleukin-10 and C-reactive protein levels were determined by ELISA to analyze the quantity change and clinical significance of MDSCs. Results The percentage of MDSCs in peripheral blood of healthy volunteers was (1.13 +0. 25) %. At days 1,2, 3 and 7 after injury, the percentage of MDSCs in peripheral blood were (1.20 +0.22) %, (6.44 + 0.35) %, (13.84 ± 2.07) % and (15.60 ± 1.63) % respectively in patients with infection and multiple injury, whereas (1.29 ±0. 30)%, (4.93 +0. 32)%, (5.15 ±0. 21)% and (3.77 ± 0.34) % respectively in patients without infection. The percentages of MDSCs in two groups showed significant differences at days 2, 3 and 7 after trauma (P＜0.05). No correlation was found between MDSCs percentage in peripheral blood and injury severity score, serum interleukin-10 or C reactive protein in patients with multiple injury (P ＞ 0.05). Conclusions The increase of proportion ofMDSCs in peripheral blood correlates with the onset of infection in patients with multiple injury, indicating that the expansion of MDSCs in peripheral blood may play important roles in immune dysfunction after multiple injury.