革兰阴性菌脓毒血症患者早期NK细胞及可溶性粒细胞靶受体对病人预后的影响

The prognostic influence of NK cells and sTREM-1 on the patients with early severe Gram-negative sepsis

目的:探讨革兰阴性菌脓毒血症患者早期NK细胞及血清可溶性粒细胞靶受体(sTREM-1)对病人预后的影响。方法:脓毒血症发生后12h内,采集49例高度怀疑革兰阴性菌感染患者的外周血,应用流式细胞术分析NK细胞,ELISA法测定血清sTREM-1的浓度,同时使用生物梅里埃API20E鉴定系统进行细菌鉴定;采集16个健康人的血样品作为对照。结果:49例患者均确诊为革兰阴性菌感染。与对照组相比,脓毒血症患者外周血NK细胞明显增多(P<0.01),且淋巴细胞中NK细胞比例>20%的患者生存期长于NK细胞≤20%的患者(P<0.05)。患者血清sTREM-1水平较对照明显增高(P<0.01),且血清sTREM-1浓度>180pg/ml的患者生存期长于sTREM-1浓度≤180pg/ml的患者(P<0.05)。结论:革兰阴性菌脓毒血症患者早期NK细胞增加和血清sTREM-1水平增高可改善患者的生存期。

Objective： To explore the prognostic influence of NK ceils and soluble triggering receptor expressed on myeloid cells-1 （sTREM-1） on the patients with early severe Gram-negative sepsis. Methods： Within 12 hours of the advent of severe sepsis, blood was sampled from 49 patients who were highly suspected being infected by Gram-negative pathogens. And blood sampled from 16 healthy was as the control. NK ceils were targeted with monoclonal antibodies and were analyzed by flow cytometry. Serum sTREM-1 was determined by ELISA. At the same time pathogenic bacteria was identified by API20E system. Results： NK ceils were significantly higher in the patients with sepsis than those in the control （P〈 0.01）; and patients with NK cells 〉20% survived longer compared with those patients with NK cells ≤20%（P〈0.05）. The serum levels of sTREM-1 were significantly elevated in the patients with severe sepsis compared with the controls （P〈 0.01）; and patients with sTREM-1〉180 pg/ml survived longer compared with those patients with sTREM-1 ≤ 180 pg/m （P〈 0.05）. Conclusion： The increase of NK cells and serum level of sTREM-1 can improve the survival of patients with early severe Gram-negative sepsis.