Functions Of Polymorphonuclear Neutrophils In Patients With Multiple Organ Dysfunction Syndrome

Objective: To study the changes of polymorphonuclear neutrophils' functions in different periods of multiple organ dysfunction syndrome, and to evaluate the role of PMN in this condiction.Methods: 10 patients diagnosed as SIRS and MODS in intensive care unit in ChangHai Hospital were included . 3ml peripheral blood was collected and heparnized in different periods of multiple organ dysfunction syndrome from all patients, and the the PMNs' functions were determined with flow cytometry. The functions measured included chemotactic activity of PMNs that migrate through cell culture inserts towards a concentration gradient of the chemoattractant fMLP, phagocytic activity of PMNs with ingestion fluorescein (FITC)-labelled opsonized bacteria (E. coli) and oxidative respiratory burst activity induced by E. coli. The serum level of TNF- α ,, IL-8. NO were also measured by ELISA, and The serum of neurophil elastase activity, myeloperoxidase activity also were detected at the same time. The related parameters of 8 healthy volunteers were also detected as normal.Results:(1)The changes of PMNs' functions:In stage of SIRS , the PMNS' activities were significantly higher than those obtained from healthy volunteers(P < 0.01). In the stage of MODS, the PMNS' chemotactic, phagocytic function were decrease markedly than the healthy control(P <0. 01),but the oxidative respiratory burst activitie was significantly higher than those obtained from SIRS (P<0. 01). (2)The serum of neurophil elastase activity in patients was MODS group>SIRS group>normal control group(P<0. 01). (3)All healthy volunteers' MPXI (myeloperoxidase index)were in normal ranges, and those diagnosed as SIRS were changes from +20 to +30, and all MODS patients' MPXI were more than +30. ? The serum TNF-a > IL-8 and NO levels in patients of SIRS and MODS was significantly different to those of normal control (P<0. 01), and those of MODS group was significantly different to those of SIRS group(P < 0.01). (5) The activities of PMN were inversely related to the serum level of N0(r= -0. 86).Conclusions: Our results showed the functions of PMN were different in different stages of MODS. In MODS, PMN in a dysfunctional state characterized as decreased innate immunity response and increased injury on auto-constitution with which might indicate bad prognosis of patients.