严重脓毒症患者红细胞免疫粘附功能变化及其临床意义

The clinical significance of change in erythrocyte immune function in severe sepsis

目的：了解严重脓毒症患者红细胞免疫粘附功能的变化，探讨红细胞免疫粘附功能在严重脓毒症向多脏器功能失常综合征（ＭＯＤＳ）转变中的意义。方法：采用酵母菌致敏法测定２０例严重脓毒症患者和２０例正常人的红细胞免疫粘附功能，以红细胞Ｃ３ｂ（ＲＢＣＣ３ｂ）受体花环率和红细胞免疫复合物（ＲＢＣＩＣ）花环率作判断指标。结果：严重脓毒症患者ＲＢＣＣ３ｂ受体花环率明显低于正常对照组（０．１０５±０．０３２比０．１７４±０．０６５，Ｐ＜０．０１），ＲＢＣＩＣ花环率明显高于正常对照组（０．０９１±０．０３１比０．０４１±０．０２５，Ｐ＜０．０１）；严重脓毒症患者发生ＭＯＤＳ组ＲＢＣＣ３ｂ受体花环率明显低于病情好转组（０．０６８±０．０２３比０．１４２±０．０３２，Ｐ＜０．０１），ＲＢＣＩＣ花环率明显高于病情好转组（０．１３４±０．０３２比０．０６４±０．０３２，Ｐ＜０．０１）。结论：严重脓毒症患者红细胞免疫粘附功能明显下降。

Objective:To investigate the change in erythrocyte immune function and its clinical significance in severe sepsis.Methods:The erythrocyte immune function in 20 patients with severe sepsis and 20 normal volunteers was measured.It was represented by red blood cell(RBC)C3b receptor ratio (RBCC3bRR) and RBCimmune complex ratio (RBCICR).Results:RBCC3bRR in patients with severe sepsis was significantly lower than normal controls (0 105±0 032 vs.0 174 ±0 065, P <0 01),and it was much lower in patients developing MODS than in patients with recovery (0 068±0 023 vs.0 142±0 032, P <0 01).However,RBCICR was markedly elevated in patients with severe sepsis compared to normal controls (0 091±0 031 vs.0 041±0 025, P <0 01),and it was much higher in the MODS group than in recovery group in patients with severe sepsis (0 134±0 032 vs.0 064±0 032, P <0 01 ).Conclusions:Our data suggest that the erythrocyte immune function appears to be reduced in patients with severe sepsis,which may be associated with the state of illness.