Post-traumatic Changes Of Lymphocyte Subsets After Severe Multiple Injuries

Background: One of the body's responses to trauma comprises a systemic drive to restore homeostasis. We monitor vital signs to gauge injury severity and response to resuscitation efforts. Many patients who survive initial resuscitation efforts die as inpatients from resultant infectious complications and multiple organ failure (MOF), As early as the 1960s, post-hemorrhagic organ damage was documented to occur at sites remote from the initial insult, Injury severity strongly correlates to the magnitude of this immune response. While some post-traumatic immune perturbations are appropriate, others are potentially maladaptive and have been linked to infectious complications and MOF.Objective: To observe the change of T, B, NK lymphocyte subsets, cytokines-6, TNF-αand its relation with injury severity, elderly and gender, following severe multiple injury.Methods: 120 multiple injury patients is divided into two groups by ISS:a severe group (group A, 79 patients, ISS≥16) and a non-severe group (group B, 41 patients, 8≤ISS<16). T, B, NK lymphocytes and IL-6,TNF-αfrom the periphery blood of 120 patients with trauma on the 1st day, 3rd day, 7th day and 40 health control subjects (group C) were assessed by quantitative flow cytometry and analyzed by SPSS 16.0.Results: CD³⁺, CD⁴⁺ and CD⁸⁺ lymphocyte counts and CD⁴⁺/CD⁸⁺ value in group A were significantly lower than those in the group C on the 1st day, 3rd day and 7th day (P<0.05).CD³⁺, CD⁴⁺ lymphocyte counts in group A were significantly lower than those in the group C on the 1st day and 3rd day. CD³⁺, CD⁴⁺ lymphocyte counts and CD⁴⁺/CD⁸⁺ value on the 1st and 3rd day negatively correlated with ISS (P<0.05). In group A, CD³⁺, CD⁴⁺ and CD⁴⁺/CD⁸⁺ in group Ay were significantly higher that those in group Ao. There were no differences between the group Am and Af. Early after injury, the level of IL-6, TNF-αwere significantly increased, which reflect the severity of injury post-trauma.Conclusion: T cells play an important role in suppression of T cell-mediated immunity after severe injury. The variation of T cells can help evaluate prognosis and predict the risk of complicating sepsis in patients with severe multiple injury. The level of inflammatory response can be reflected by IL-6 and TNF-α.