抗生素诱导内毒素释放对感染患者T淋巴细胞免疫功能的影响

Influence of T cells functions′ change in antibiotics induced endotoxin releasing in severe infection patients

目的探讨应用β-内酰胺类抗生素治疗严重感染患者后机体内毒素(LPS)水平、T淋巴细胞功能的变化及差异。方法选择20例革兰阴性杆菌感染的患者,10例1组,分别用亚胺培南(IPM)、头孢哌酮(CPZ)治疗,于用药前、后抽取静脉血,检测血浆内毒素脂多糖(LPS)水平及T细胞表面CD抗原的表达,分析其变化(P<0.05)。结果用药后两组患者血浆LPS水平升高,其中CPZ组增高幅度较IPM组大,差别有统计学意义;两组患者CD3、CD4表达在用药前后均未见明显差别(P>0.05),CD25、CD28表达在用药后均明显高于用药前,且差别有统计学意义(P<0.05);两组间进行比较,CPZ组CD4、CD25表达略高于IPM组,但差别无统计学意义(P>0.05)。结论应用不同种类抗生素治疗严重感染患者时,血浆LPS水平表达存在差异;用药后T淋巴细胞活化抗原标志表达升高,提示在抗生素诱导的内毒素释放过程中,T淋巴细胞发挥了一定的免疫调节作用。

Objective To explore the changes in plasma levels of lipopolysaccharride(LPS)and T cell functions in severe infected patients treated with Imipenem(IPM) and Cefoperazone(CPZ).Methods Twenty patients infected with gram negative bacilli were divided into two groups,10 cases per group and treated with IPM and CPZ respectively,venous blood samples were harvested before and 24h after the use of antibiotic for the test of the plasma levels of LPS and the CDs expression also determined.Results The plasma levels of LPS in both groups were elevated after treated with antibiotics,the level in CPZ group was more than that of IPM group significantly.The expression of CD3 and CD4 had no change in two groups before and after treated with antibiotics,whereas the expression of CD25 and CD28 were much higher after the use of antibiotics compared with before use of it.The expression of CD4 and CD25 in CPZ group was slightly higher than those in IPM group.However,the difference was not significant(P>0.05).Conclusion The release of LPS from the bacteria could be induced by the different kinds of antibiotics in the treated severe infected patients in different releasing amount,T cell active antigens expressed higher after the use of antibiotics,indicated T cells play an immune regulatory role in the infectious processes.