不稳定骨盆骨折患者外周血T淋巴细胞亚群的动态变化及临床意义

Dynamic change and clinical significance of peripheral T-lymphocyte subpopulations in patients with unstable pelvic fracture

目的探讨不稳定骨盆骨折患者外周血T淋巴细胞亚群的动态变化及其临床意义。方法将27例不稳定骨盆骨折患者(骨盆骨折组)和16例健康志愿者(对照组)纳入本研究。采用双抗体标记流式细胞分析技术测定对照组和不稳定骨盆骨折患者在入院当时、伤后第3天、第5天和第7天4个时间点的外周血CD4+亚群、CD8+亚群的百分率及两者比值CD4+/CD8+。结果本组不稳定骨盆骨折患者外周血T淋巴细胞亚群中发生明显变化的主要是CD4+亚群和CD4+/CD8+比值。不稳定骨盆骨折患者外周血CD4+亚群和CD4+/CD8+比值在伤后第3天和第5天均处于最低值,而至伤后第7天,上述指标虽然未完全恢复正常,但已经明显有所改善。结论对于不稳定骨盆骨折患者患者,免疫调节功能在伤后第7天才开始恢复,因而对于这一类患者,至少在创伤后病情稳定一周以上方能考虑进行内固定手术,这样可能有助于减少患者的免疫损害。

Objective To investigate the dynamic change and clinical significance of peripheral T-lymphocyte subpopulations in patients with unstable pelvic fracture. Methods Twenty-seven patients with unstable pelvic fracture and sixteen healthy volunteers （control） were enrolled in this study. The patients were all treated conventionally. The CD4^＋and CD8^＋ subpopulations of T-lymphocyte in the peripheral blood were detected respectively at admission of hospitalization, 3rd, 5th, and 7th day after trauma by double antibody labeling and flow cytometry. Results The CD4^＋T-lymphocytes and CD4^＋ / CD8^＋ ratio of peripheral blood in patients with unstable pelvic fracture changed significantly hfbvduring the process. The CD4^＋Tlymphocytes and CD4^＋/CD8^＋ ratio of peripheral blood were at a minimum on 3rd and 5th day, and improved significantly on the 7th d after trauma. Conclusions In the pathophysiological procedure of patients with unstable pelvic fracture, the correcting of T-lymphocyte subpopulations regulating network is effective until the 7th d after trauma. It is suggested to consider the definitive fixation of the pelvic fracture for patients with trauma for more than one week.