创伤后多器官功能障碍综合征患者外周血髓源抑制细胞细胞的表达

Expression of myeloid-derived suppressor cells in patients with post-traumatic multiple organ dysfunction syndrome

目的探讨创伤后多器官功能障碍综合征(MODS)患者外周血髓源抑制细胞(MDSCs)的表达在诊断MODS疾病严重程度和预后判断中的临床意义。方法分别采集66例MODS患者、78例非MODS患者和37例健康志愿者外周血,以CD14-CD11b+CD33+作为MDSCs的标志,采用流式细胞术检测MDSCs细胞的表达;以MODS评分评估疾病严重程度;采用酶联免疫吸附法(ELISA)测定血清白细胞介素-10(IL-10)和肿瘤坏死因子-α(TNF-α)水平,并分析患者MDSCs的表达与疾病严重程度评分和IL-10和TNF-α水平的相关性。结果 MODS患者外周血CD14-CD11b+CD33+细胞表达为(11.84±2.18)%明显高于非MODS组的(6.52±0.37)%和健康对照组的(1.18±0.22)%(P<0.05);MODS患者死亡组(15.66±1.68)%较存活组(9.48±1.56)%明显升高(P<0.05)。MODS患者血清IL-10、TNF-α水平较非MODS组和健康对照组明显增高(P<0.05)。MODS患者中死亡组血清IL-10、TNF-α水平较存活组明显升高(P<0.05);相关分析显示,MODS患者外周血CD14-CD11b+CD33+细胞表达率与TNF-α水平和MODS评分成正相关(r分别为0.342 6、0.387 9,P<0.05)。结论外周血MDSCs水平变化可能与疾病的严重程度和预后相关。

Objective To study the quantity change and significance of myeloid‐derived suppressor cells（MDSCs） in patients withpost‐traumaticmultipleorgandysfunctionsyndrome（MODS）.Methods 66patientswithMODS,34patientswithnon‐system‐ic inflammatory response syndrome（SIRS）and 37 healthy volunteers were enrolled in this study .Peripheral blood was collected and CD14-CD11b＋ CD33＋ were used as markers of MDSCs .The percentage of MDSCs was determined by flow cytometry and serum interleukin‐10（IL‐10） and tumor necrosis factor‐α（TNF‐α） levels were determined by ELISA .The MODS scoring system was used to assess patients′disease severity .The relationship was analyzed between MDSCs and TNF‐αand MODS score .Results The per‐centage of MDSCs in peripheral blood of healthy volunteers was（1 .18 ± 0 .22）% .after MODS ,the percentage of MDSCs in periph‐eral blood was（11 .84 ± 2 .18）% and（6 .52 ± 0 .37）% in patients with non‐MODS ,the percentages of MDSCs in three groups showed significant differences（P〈0 .05） .Serum IL‐10 and TNF‐αin patients with MODS group and non‐MODS group were signif‐icant differences（P〈0 .05） .The correlation was found between MDSCs percentage in peripheral blood and MODS score and TNF‐α（r=0 .342 6 ,0 .387 9 respectively ,P〈0 .05） .Conclusion The increase proportion of MDSCs in peripheral blood correlates with the onset of infection in patients with MODS ,indicating that the expansion of MDSCs in peripheral blood may play important roles in immune dysfunction after MODS .