中性粒细胞凋亡及caspase-3活性与多发伤患者MODS的关系

目的 研究外周血中性粒细胞凋亡及caspase-3的活性,探讨其在多发伤患者发生MODS中的意义.方法 选择多发伤患者55例,以是否发生MODS分为MODS组和非MODS组,采用流式细胞仪和TUNEL法定量检测外周血中性粒细胞的凋亡情况,流式细胞仪检测激活的caspase-3百分比,ELISA法检测血清IL-6,IL-10的水平.并分析中性粒细胞凋亡与IL-6和IL-10的相关性.结果 多发伤患者MODS组与非MODS组相比较,外周血中性粒细胞凋亡明显延迟,激活的caspase-3百分比明显降低(P<0.05).MODS患者血清IL-6水平增高,IL-10水平降低.MODS患者外周血中性粒细胞凋亡与其IL-6水平呈负相关,与IL-10水平呈正相关.结论 外周血中性粒细胞凋亡延迟,caspase-3活性下降,与多发伤患者发生MODS相关,IL-6和IL-10参与其调控.

Relationship of neutrophil apoptosis and caspase-3 activity with multiple organ dysfunction syn-drome after multiple injury

Objective To investigate apoptosis of polymorphonuclear neutrophil and activity of caspase-3 in the peripheral blood and discuss their correlation with development of multiple organ dysfunc- tion syndrome (MODS) after multiple injury. Methods A total of 55 patients with multiple injury were included in the prospective study, and divided into two groups, ie, MODS group (multiple injury patients who developed MODS,) and non-MODS group (multiple injury patients who were free from MODS). The activity of caspase-3 was detected by flow cytometry and the serum levels of IL-6 and IL-10 were detected by ELISA. Then, we evaluated whether the neutrophil apoptesis was correlated with the ser- um levels of IL-6 and IL-10 in patients with MODS. Results Compared with non-MODS group, neu- trophil apoptesis was significantly reduced and activated caspase-3 decreased significantly in MODS group (P <0.05). In MODS group, serum IL-6 was increased significantly while serum IL-10 was decreased significantly compared with non-MODS group. The apoptosis of neutrophil in multiple injury patients with MODS had a negative correlation with IL-6 levels but a positive correlation with IL-10 levels. Conclu- sions The delayed apoptosis of neutrophil due to decreased activated caspase-3 may play partial roles in the development of MODS after multiple injury. IL-6 and IL-10 may contribute to the apoptotic changes.