早期切痂及微粒皮移植对大面积深度烧伤病人免疫细胞的影响

目的　探讨早期切痂及微粒皮移植对大面积深度烧伤病人外周血T淋巴细胞亚群及自然杀伤细胞 (NK)的影响。方法　以直标荧光抗体及流式细胞术检测 8例大面积深度烧伤病人在早期切痂及微粒皮移植术前后 ,及 5例整形病人术前外周血CD3 、CD4 、CD8 细胞及NK细胞变化。结果　大面积深度烧伤后 ,患者外周血中表达CD3 、CD3 CD4 、CD3 CD8 、CD1 6 CD5 6 的细胞较对照组明显减少 (P <0 .0 1 )。烧伤后早期切除焦痂 ,并移植自体微粒皮复合同种异基因皮肤后 ,患者外周血中表达CD3 、CD3 CD4 、CD3 CD8 、CD1 6 CD5 6 的细胞较对照组明显增加 (P <0 .0 5 )。结论　早期切痂及微粒皮移植可以明显改善大面积深度烧伤病人的免疫抑制状态 ;对烧伤切痂植皮术前后进行免疫监测 ,可以对患者感染风险进行预测 ,从而指导临床治疗。

Effect of early escharectomy and skin graft on immune cells of severe burn patients

Objective To investigate the alteration of T lymphocytes subpopulation and NK cells in severe burn patients who received escharectomy and skin graft.?Methods Blood samples from 5 healthy persons and 8 severely burned cases were examined before and after the operation.?Flow cytometry was applied to detect the CD3 ,CD4 ,CD8 and NK cells in the samples.?Results T lymphocytes subpopulation and NK cells significantly decreased in peripheral blood of severely burned patients as compared with the control (P<0.01).?They recovered remarkably after the operation (P<0.05).?Conclusion Escharectomy and skin grafting could prevent immune depression in severely burned patients.?Supervision of the alteration of immune system of operated patients is helpful for prevention of infection.