创伤后多脏器功能衰竭患者白细胞流变性和细胞粘附分子水平的变化

目的 探讨创作后多器官功能衰竭（ＭＯＦ）患者白细胞流变性和细胞粘附分子（ＣＡＭｓ）水平的变化。方法 采用ＤＸＣ－３００Ａ型核孔膜红细胞变形能力测定仪、ＪＹＪ－Ⅲ型体外血栓血小板粘附两用仪、酶联免疫吸附法（ＥＬＩＳＡ）,分别检测了３６例创伤后ＭＯＦ患者、３１例创伤患者和３５例健康人外周血液白细胞变形能力（ＬＤ）、白细胞粘附功能（ＬＡＦ）、白细胞ＣＤ１８表达、血浆可溶性细胞间粘附分子－１（ｓＩＣＡＭ－

Changes of leukocyte rheologic characteristics and cell adhesion molecules in patients with multiple organ failure after severe trauma

Objective To explore the changes of leukocyte rheologic characteristics and of cell adhesion molecule in patients with multiple organ failure(MOF) after severe trauma. Methods By using the erythrocyte deformability apparatus,platelet and thrombus adhesion dual purpose apparatus and enzyme linked immunosorbent assay(ELISA),We measured the leukocyte deformability(LD),leukocyte adhesion function(LAF),leukocyte CD18 expression,soluble intercellular adhesion molecule 1(sICAM 1) and soluble vascular cell adhesion molecule(sVCAM 1)concentration in 36 MOF patients ,31 trauma patients, and 35 to be controls. ResultsThe leukocyte filtration index(LFI),leukocyte adhesion rate(LAR),leukocyte CD18 expression, and sICAM 1 and sVCAM 1 concentration were significantly higher in MOF patients than in controls and trauma patients( F =68 45 116 20, q =12 161 21 374, P <0 00) , and the changes of these indicotors in MOF deaths were more obvious than those in MOF survivors ( t =6 920 11 665, P <0 00). The LFI and LAR in MOF patients were positively related to leukocyte CD18 expression, sICAM 1, and sVCAM 1 concentration( r =0 691 0 844, P <0 001); LFI was positively related to LAR( r =0 711, P <0 001). Conclusion The abnormalities of leukocyte rheologic characteristics and CAMs might be closely related to the occurrance of MOF and the severeness of pathologic changes.