CD14＋HLA-DR low／-预测急性胰腺炎严重程度的作用研究

The prognostic value of CD14＋HLA-DRlow/-for evaluating the severity of acute pancreatitis

目的：探讨CD4＋CD25＋/highCD127low/-和CD14＋HLA-DRlow/-预测急性胰腺炎严重程度的作用。方法流式细胞仪检测AP患者（ acute pancreatitis ， AP）外周血CD4＋CD25＋/high CD127 low/-、CD14＋HLA-DRlow/-、CD64指数的水平，并与C-反应蛋白（CRP）、急性生理学与慢性健康状况评分系统Ⅱ（ APACHEⅡ）评分、CT严重度指数（ CTSI ）进行相关性分析。结果重症胰腺炎、轻型胰腺炎组CD4＋CD25＋/high CD127 low/-、CD14＋HLA-DRlow/-、CD64指数均明显高于正常对照组，重症胰腺炎组CD14＋HLA-DRlow/-高于轻型胰腺炎组；动态观察结果显示，轻型胰腺炎组CD4＋CD25＋/high CD127 low/-、CD14＋HLA-DRlow/-、CD64指数、CRP均先升高后明显回落；而重症胰腺炎组却持续升高；相关性分析显示，CD14＋HLA-DRlow/-与 CD64指数、CRP、APACHEⅡ、CTSI 成明显正相关。结论 CD14＋HLA-DRlow/-与AP严重程度密切相关，可作为疾病严重程度的指标。

Objective To investigate the prognostic value of CD 4＋CD25＋/high CD127 low/-and CD14＋HLA-DRlow/-for evaluating the severity of acute pancreatitis .Methods The percentages of CD4＋CD25＋/highCD127low/-and CD14＋HLA-DRlow/-and the CD64 index were measured by flow cytometry in pa-tients with acute pancreatitis （ including 43 cases of mild acute pancreatitis and 24 cases of severe acute pan-creatitis）.Moreover, the levels of C-reactive protein （CRP）, acute physiology and chronic health evaluationⅡ（ APACHEⅡ） score and CT severity index （ CTSI ） were detected for a correlation analysis .Results The percentages of CD4＋CD25＋/highCD127low/-and CD14＋HLA-DRlow/-and the CD64 index in patients with severe and mild acute pancreatitis were significantly higher than those in healthy subjects .Patients with se-vere acute pancreatitis showed higher percentages of CD 14＋HLA-DRlow/-than patients with mild acute pan-creatitis.With the disease progression, the CD64 index and the levels of CD4＋CD25＋/highCD127low/-, CD14＋HLA-DRlow/-and CRP were significantly dropped after an initial increase in patients with mild acute pancrea -titis, while these indexes were continuously elevated in patients with severe acute pancreatitis .The percent-age of CD14＋HLA-DRlow/-was positively correlated with CD64 index, CRP level, APACHEⅡ score and CTSI.Conclusion CD14＋HLA-DRlow/-level was closely related to the severity of acute pancreatitis , which could be used as immune parameter for the estimation of the clinical severity of acute pancreatitis .