摘要
目的:研究不同程度开放性骨折早期机体免疫功能变化.方法:按照朱通伯的开放性骨折分类标准,将21例患者分为两组:轻伤组,为Ⅰ,Ⅱ度开放性骨折(共10例);重伤组,为Ⅲ度开放性骨折(共11例).用APAAP法和生物学测定法分别检测在伤后当日,5d,10d,15d患者外周血单个核细胞的T淋巴细胞亚群变化和经植物血凝素(PHA,10mg/L)刺激后IL-2活性及IL-2R(Tac抗原)表达变化.结果:伤后当日,5d两组Leu4(总T细胞)、Leu3a(辅助性T细胞)及Tac阳性细胞百分比明显下降(P<0.05,P<0.01),Leu2a(抑制性T细胞/杀伤性T细胞)细胞百分比无显著变化(P>0.05);IL-2产生明显减少(P<0.01).轻伤组下降各值在伤后5d开始回升,伤后10d,15d接近正常;重伤组各值下降比轻伤组更为明显,而且回升缓慢.结论:开放性骨折早期Th淋巴细胞功能受损,IL-2活性和IL-2R表达受抑,免疫功能下降程度与创伤严重程度相关.
AIM: To study injury induced immunosuppressionin open fractures of different grades. METHODS: Accordingto Zhu Tongbo's classification of open fractures, 21 patientswere divided into two groups: group A--Type fractures(10 cases); group B Type fractures (11 cases). Peripheral blood mononuclear cells (PBMC ) from the peripheralblood samples of the patients obtained at 0 d, 5 d, 10 d, 15 dpost--injury were collected. Percentages of total T lymphocytes, helper T cells, suppressor/cytotoxic T cells and Taopositive cells (from the PBMC cultures activated by PHA, 10mg/L) identified by monoclonal antibodies (McAb) of Leu4,Leu3a, Leu2a and anti-Tao respectively were assessed by using APAAP method. Production of IL--2 in the cultures asmentioned above by determining the extent of proliferation ofan IL--2 dependent cell line (CTLL2) was assessed by usingMTT method. RESULTS: During the 15 days after injury,percentages of Leu4, Leu3a cells and Tac positive cells andproduction of IL--2 by PBMC in both groups reduced significantly as compared with the normal values or the controls (P<0. 05,P<0. 01 ) and the parameters above in group A experienced a transient decline in 5 days which was followed by arapid restoration whereas those in group B had a profound decrease and remained at a low level. CONCLUSION: In theearly stage of open factures helper T cells are impaired andproduction of IL--2 and expression of IL--2R are reduced. Theimmunosuppression following open fractures parallells theseventy of the trauma.
出处
《第四军医大学学报》
CAS
1999年第1期64-67,共4页
Journal of the Fourth Military Medical University
关键词
骨折
开放性骨折
T细胞亚群
Tac抗原
IL-2
fractures, open, T--lymphocyte subsets, interleukin2, receptors, interleukin--2