脓毒症患者外周血CD^＋4CD^＋25调节性T细胞水平与APACHEⅡ评分相关性的临床研究

Clinical study on correlation between the level of CD^＋4CD^＋25 regulatory T cells in peripheral bloodand APACHE Ⅱ scores in patients with sepsis

目的探讨脓毒症患者外周血CD^＋4CD^＋25调节性T细胞水平及其与疾病严重程度的相关性。方法选取脓毒症患者36例，依据诊断标准分为脓毒症组10例、严重脓毒症组15例和脓毒性休克组11例，以健康志愿者5例作为对照组。于人ICU时抽取外周血，分离淋巴细胞，以藻红蛋白（PE）标记的抗人CD4和异硫氰酸荧光素（FTTC）标记的抗人CD25单克隆抗体标记细胞，流式细胞仪检测CD^＋4CD^＋25调节性T细胞含量。并结合各组不同时间点的急性生理学及慢性健康状况（APACHE）Ⅱ评分，分析CD^＋4CD^＋25调节性T细胞与APACHEⅡ评分的相关性。结果脓毒症组、严重脓毒症组和脓毒性休克组外周血CD^＋4CD^＋25调节性T细胞含量[分别为（10．31±2．32）％、（14．27±3．33）％、（15．32±3．98）％]均较对照组[（5．48±0．98）％]显著增高（P〈0．05或〈0．01）。各组CD^＋4CD^＋25调节性T细胞水平与APACHEII评分呈明显正相关，相关系数分别为0．829（P=0．032）、0．868（P=0．021）、0．913（P=0．009），总相关系数为0．903（P=0．013）。结论脓毒症患者外周血CD^＋4CD^＋25调节性T细胞明显升高，且与疾病严重程度相关。

Objective To evaluate the correlation between the level of CD^＋4CD^＋25 regulatory T cells in peripheral blood and disease severity in patients with sepsis. Methods Thirty-six septic patients and 5 healthy controls were enrolled. Septic patients were divided into sepsis group （n=10）, severe sepsis group （n=15） and septic shock group （n=11）. The lymphocyte was seperated from peripheral blood and marked by PE-CD4 and FITC-CD25 monoclonal antibody, the level of CD^＋4CD^＋25 regulatory T cells was detected by flow cytometry, and the clinical data of APACHE Ⅱ scores of septic patients was considered in 24 hours. The correlation between level of CD^＋4＋CD^＋25 regulatory T cells in peripheral blood and APACHE Ⅱ scores in septic patients was analyzed. Results Compared with the healthy controls [（5.48±0.98）%], the level of CD^＋4CD^＋25 regulatory T cells in sepsis group （10.31±2.32） %, severe sepsis group （14.27±3.33）%, septic shock group （15.32±3.98） % had a significant increase （P 〈 0.05 or 〈 0.01 ）. The log value of regulatory T cells in each group correlated positively with the APACHE Ⅱ scores （r = 0.829, P = 0.032; r = 0.868, P = 0.021; r = 0.913, P = 0.009）, and the total coefficient of correlation was 0.903 （P = 0.013）. Conclusion The level of CD^＋4CD^＋25 regulatory T cells in peripheral blood in septic patients has an abnormal increase, and their levels are related with the severity of disease.