| Objective To investigate the changes and clinical significance of the expression of activation inducer molecule T lymph cell CD69 and CD14~+ monocyte human leukocyte antigen(locus)DR on peripheral blood mononuclear cells in sepsis.The purpose of this study is to demonstrate the clinical significance of T lymphcell CD69 in sepsis.Methods To measure the r lymph cell CD69,CD14~+ monocyte human leukocyte antigen(locus)DR expressions of the 30 cases of septic patients and the 30 cases of SIRS afetr operation with first day and third day from May 2007 to December 2008 admitted to the Department of the intensive care unit(ICU)of The First Affiliated Hospital of Kunming Medical College with flow cytometry(FCM)and monoclonal antibodies,according to diagnostic standards made by American College of Chest Physicians/Society of Critical Care Medicine(ACCP/SCCM)definitions conference in Washington in 2001,which were distributed into two groups according to clinical patter:sepsis group and SIRS group,and were compared with normal subject group with 10 healthy people.And the same time,throw the correlation analysis with the T lymph cell CD69,CD14~+ monocyte human leukocyte antigen(locus)DR expressions of the 30 cases of septic patients and the 30 cases of SIRS afetr operation with the first day and third day.And each immunity index throw the correlation analysis with the acute physiology and chronic health evaluationⅡ(APACHEⅡ)was analyzed.Result there are no significant difference in the T lymph cell CD69,CD14~+ monocyte human leukocyte antigen(locus)DR expressions was found in patients with sepsis after operation in the first day or the third day when compared with the SIRS group(P＞0.05),and each group compared with the normal group have a significant difference(P＜0.05),There are lower than the normal group.The positive correlation with the T lymph cell CD69 and CD14~+ monocyte human leukocyte antigen(locus)DR expressions of the septic group and the SIRS group afetr operation with the first day and the third day[the first day with septic group:r=0.755,P=0.000;the third day with septic group:r=0.91,P=0.000;the first day with SIRS group: r=0.931,P=0.001;the third day with SIRS group:r=0.907,P=0.000]。There was significant negative correlation between the T lymph cell CD69 or CD14~+ monocyte human leukocyte antigen(locus)DR levels and acute physiology and chronic health evaluationⅡ(APACHEⅡ)(the first day with septic group CD69:r=-0.84,P=0.000,HLA-DR:r=-0.822,P=0.000;the third day with septic group CD69:r=-0.806,P=0.000;HLA-DR:r=-0.782,P=0.000; the first day with SIRS group CD69:r=-0.815,P=-0.000,HLA-DR:I-=-0.866, P=0.000;the third day with SIRS group CD69:r=-0.796,P=0.000,HLA-DR: r=-0.803,P=0.O00).Conclusion There were significantly immunoparalysis in septic patients and SIRS patients after operation in the first day and third day,and have a no significant difference with each other,and comfirmed that the SIRS patients have over inflammatory reaction and immunoparalysis,and have a common view with Bone' s concept in 1996.In predicting the situation of immunity of septic patients and SIRS,T lymph cell CD69 level might be as valuable as CD14~+ monocyte human leukocyte antigen(locus)DR level. To evalued the situation of immunity of the expression of activation inducer molecule Tlymph cell CD69 and CD14~+ monocyte human leukocyte antigen (locus)DR levels in the septic patient and the SIRS patient,and each has a negtive correlation with the APACHEⅡscore,degree of T lymph cell CD69 and CD14~+ monocyte human leukocyte antigen(locus)DR levels is correlated to the intensity of sepsis.The immunity index T lymphcell CD69 and CD14~+ monocyte human leukocyte antigen(locus)DR levels can better reflect the situation of immunity in the septic patient.Supervising the changes of the T lymphcell CD69 and CD14~+ monocyte human leukocyte antigen (locus)DR levels in sepsis can reflect the degree of the severity of sepsis and become prognostic marker in certain degree,and have important clinical value。... |
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