CD14＋/HLA-DR＋单核细胞对脓毒症患者预后判断的应用研究

Clinical significance of CD14＋/HLA- DR＋ mononuclear cells in the prognosis of sepsis

目的 探讨CD14＋/人类白细胞抗原-DR＋（HLA-DR＋）单核细胞在脓毒症发展进程中的变化情况及对预后判断的临床意义.方法 用流式细胞术（flow cytometry, FCM）检测脓毒症患者（预后良好组和预后不良组）及正常对照组全血中的单核细胞表面CD14＋/HLA-DR＋的表达情况.对10例脓毒症患者CD14＋/HLA-DR＋单核细胞进行连续监测. 结果 103例脓毒症患者CD14＋/HLA-DR＋单核细胞明显低于正常对照组（t=8.147,P〈0.05）;脓毒症患者预后良好组CD14＋/HLA-DR＋单核细胞与预后不良组比较差异有统计学意义（χ2=14.9,P〈0.05）;对10例脓毒症患者CD14＋/HLA-DR＋单核细胞进行连续监测,发现该指标与疾病的发展变化及预后转归有一定的相关性.结论 CD14＋/人类白细胞抗原-DR＋单核细胞的检测及动态连续监测对脓毒症患者的预后判断有重要意义,对该病的临床治疗有积极的指导作用.

Objective To investigate the clinical significance of CD14＋/HLA - DR＋ mononuclear cells in disease progression and prognosis of sepsis. Methods CD14 ＋/HLA - DR ＋ mononuclear cells in whole blood of sepsis patients and control group were detected by flow cytometry （FCM）, and sepsis patients were divided into good prognosis group and poor prognosis group. Meanwhile, CD14 ＋/HLA -DR ＋ mononuclear cells of 10 patients were continuously monitored. Results CD14 ＋/HLA - DR ＋ mononuclear ceils of 103 sepsis patients were significantly lower than those of the control group （ t = 8. 147 ,P 〈 0.05 ） ; the results of CD14 ＋/HLA - DR ＋ mononuclear ceils test between good prognosis group and poor prognosis group of 103 sepsis patients had significant difference （X2 = 14. 9,P 〈 0.05 ）. Meanwhile, CD14 ＋/HLA - DR ＋ mononuclear cells changes were correlated with disease progression and prognosis based on continuous monitoring. Conclusion CD14 ＋/HLA - DR＋ mononuclear cells is significant in the prognosis of sepsis, and its dynamic continuous monitoring have a positive guidance to the clinical treatment of this disease.