肺部感染患者外周血中性粒细胞黏附分子CD11b CD18髓过氧化物酶的变化及临床意义

Changes of adhering molecules CD11b,CD18,myeloperoxidase(MPO) expression of the neutrophil in peripheral blood of pneumonia patients

目的了解肺部感染患者外周血中性粒细胞功能即表达黏附分子CD11b、CD18、髓过氧化物酶(MPO)的变化及临床意义。方法应用流式细胞仪检测30例普通肺部感染患者治疗前后、18例重症肺部感染患者治疗前外周血中性粒细胞表面表达黏附分子CD11b、CD18、MPO的变化,并与25例健康人进行比较。结果①普通组和重症组患者外周血中性粒细胞黏附分子CD11b、CD18表达明显高于正常对照组,有统计学意义(P<0.05或P<0.01);普通组MPO表达明显高于正常对照组和重症肺炎组,有统计学意义(P<0.01);重症组MPO明显低于普通组,有统计学意义(P<0.01)。②普通组常规治疗10 d后CD11b、CD18与治疗前相比变化不明显(P>0.05);治疗10 d后普通组MPO表达较治疗前明显降低,有统计学意义(P<0.01);治疗后各组数据均较治疗前有所降低,但仍未降至正常对照组水平,有统计学意义。结论肺部感染患者外周血中性粒细胞处于活化状态,表达黏附分子CD11b、CD18增多;中性粒细胞杀菌功能增强,表现为MPO表达增多;重症肺部感染可抑制MPO表达,从而影响中性粒细胞的杀菌功能,对患者预后不利。

Objective To investigate the functions of the neutrophils in peripheral blood of pneumonia patients, that is, the changes of expressions of adhering molecule CDllb, CD18 and myelopemxidase（ MPO）. Methods The expressions of adhering molecule CDllb, CD18 and MPO were determined by flocytometry in 30 cases of general pneumonia patients before and after treatment, and 18 cases of severe pneumonia patients before treatment, and to compare with those of 25 cases of healthy control. Results①The adhering molecule CD11b, CD18 of the neutmphils in beth peripheral blood of general pneumonia group and severe pneumonia group were higher than those in healthy control group （ P 〈 0.05 or P 〈 0.01 ）. The expression of MPO in general pneumonia group was significantly higher than that in healthy control group and severe pneumonia group（ P 〈 0.01 ）.The MPO in severe pneumonia group was significantly lower than those in general pneumonia group （ P 〈 0.01 ）. ② After treatment 10 days , the CDllb and CD18 underwent no significant changes before and after treatment, but the MPO expression were significantly elevated （ P 〈 0.05 ） ; the MPO expression were slightly elevated with no statistical significance. Conclusion Neutmphils of peripheral blood in the pneumonia patients were activated , hence increasing the expression of adhering molecule CDllb, CD18, the function of neutmphils in this group of patients were enhanced to increase the expression of MPO,the severe pneumonia may inhibit the MPO expression, hence influencing the bacteriocidal function of the neutmphils.