脱细胞异种真皮基质疗法对重度烧伤患者免疫功能的影响

Allogeneic acellular therapy on immune function of severe burns patients

目的了解脱细胞异种真皮基质疗法治疗重度烧伤患者免疫功能的变化规律,并探讨其改善免疫功能的可能机制。方法选取佛山市第一人民医院自2007年7月至2009年7月50例重度烧伤患者,随机分为脱细胞异种真皮基质治疗组(基质组)、聚维酮碘包扎治疗组(聚维酮碘组),烧伤患者于伤后第1,3,7,10天4个不同时相点,测定外周血中淋巴细胞亚群、免疫球蛋白及补体水平,另选取同期20例门诊健康体检者血标本作正常对照,两个治疗组之间以及治疗组与正常对照组之间进行统计分析,观察免疫功能的变化规律。结果重度烧伤患者伤后第1天,基质组与聚维酮碘组外周血T淋巴细胞各亚群、免疫球蛋白、补体(P均为0.0000)均明显降低,基质组第7天各项指标基本恢复至正常水平,而聚维酮碘组第10天与正常对照组相比CD3+、CD4+、CD8+T淋巴细胞亚群、IgG、IgA、IgM差异仍有统计学意义(P<0.01);基质组外周血CD3+、CD4+、CD8+T淋巴细胞亚群、IgG、IgA、IgM免疫球蛋白在第3天即开始高于聚维酮碘组(q=4.6961、3.2030、3.5306、7.4009、10.3092、5.7625,P均<0.05),差异有统计学意义。第7天、10天时更加明显(P均<0.01)。结论烧伤后机体细胞、体液免疫功能均明显降低,采用脱细胞异种真皮基质疗法可以改善机体的免疫功能。

Objective To understand the change of immune function of severe burn patients who used allogeneic acellular, and the possible mechanism that improves the immune function. Methods Fifty patients who suffered severe burns hospitalized in Foshan First People’s Hospital from July 2007 to July 2009 were randomly divided into two groups： those treated by allogeneic acellular called allogeneic acellular treatment group, others treated by povidone iodine called povidone iodine group. The lymphocyte subpopulation, immunoglobulin and the complement in peripheral blood were measured at the 1st, 3rd, 7th, 10th days after burn. At the same time 20 healthy people were selected as normal group during the same period. Results The lymphocyte subpopulation and the complement of the patients who suffered severe burn decreased obviously at the 1st day （P=0.0000）, that in the patients who used allogeneic acellular restored to normal level at the seventh day.The povidone iodine group’s CD3＋, CD4＋, CD8＋ T lymphocytes and IgG, IgA, IgM immunoglobulin had statistically significant difference at the 10th day compared with the normal group（P0.01）. At the 3rd day, the CD3＋, CD4＋, CD8＋T lymphocytes, IgG, IgA, IgM immunoglobulin of the allogeneic acellular group were signifiancly higher than that in the povidone iodine group （q=4.6961, 3.2030, 3.5306, 7.4009, 10.3092, 5.7625,P 0.05）. At the 7th, 10th day, the difference became more significant. Conclusions The cell and humoral immune function depress obviously after burn,and application of allogeneic acellular can improve immunity function.