脓毒血症患者外周血白细胞凋亡与病情及预后关系

Relationship of leukocyte apoptosis with disease severity and outcome in sepsis patients

目的通过检测脓毒血症患者外周血淋巴细胞、中性粒细胞凋亡率,以阐述白细胞凋亡在脓毒血症患者中的作用机制及其与病情及预后的关系。方法采用流式细胞仪分别测定44例脓毒血症患者外周血淋巴细胞和中性粒细胞凋亡率,与健康对照组比较,并分析其与病情及预后的关系。结果脓毒血症组淋巴细胞凋亡率明显高于对照组〔(13.06±3.23)%vs(2.85±1.19)%,P<0.05〕,而中性粒细胞凋亡率明显低于对照组〔(3.18±0.65)%vs(3.92±0.74)%,P<0.05〕。进一步分析显示,病情严重者及病情进展组分别与病情较轻者和病情好转组比较,淋巴细胞凋亡明显增强,而中性粒细胞凋亡受抑。结论脓毒血症患者存在淋巴细胞凋亡增强,中性粒细胞凋亡延缓,可能在其发病机制中具有重要作用,并且与疾病严重程度及预后相关。

Objective We investigated the early signs of apoptosis in peripheral lymphocytes and neutrophil in order to find out the mechanism of leukocyte apoptosis and its relationship with disease severity and outcome. Methods A total of 44 patients were included in the prospective study, 23 severe sepsis patients and 21 sepsis patients. In addition, 25 healthy blood donors were included for comparison. We investigated early signs of apoptosis by using flow cytometric measurement of annexin - V binding to the cell surface of peripheral lymphocytes and neutrophil . We studied whether the apoptosis level correlated with disease severity and outcome. Results The incidence of peripheral lymphocytes apoptosis was increased in sepsis ＆ severe sepsis patients （ 13.06±3.23 ） % compared with healthy blood donors （ 2.85±1.19） % （P 〈 0.05）. Meanwhile, neutrophil apoptosis was delayed significantly in sepsis ＆ severe sepsis patients （3.18±0.65）% compared with healthy control group （3.92±0.74） % （ P 〈 0.05）. Lymphocyte apoptosis was increased and neutrophil apoptosis was limited in the severe sepsis patients compared with sepsis patients. Conclusions Increased lymphocytes apoptosis and postponed neutrophil apoptosis play a significant role in sepsis patients, which correlates with disease severity and suggests poor outcome.