腹腔感染致脓毒症患者外周血SAA、PD-1及CD_4^+、CD_8^+T细胞的表达

Expression of SAA, PD-1, CD_4^+ and CD_8^+ T cells in peripheral blood of patients with sepsis caused by abdominal infections

目的探讨腹腔感染致脓毒症患者外周血血清淀粉样蛋白A(serum amyloid A protein,SAA)、程序性细胞死亡因子-1(programmed cell death-1,PD-1)、及CD4^+、CD8^+T细胞的表达。方法选择2014-01至2015-12连云港市某人民医院重症监护病房(intensive care unit,ICU)收治的37例腹腔感染致脓毒症患者为研究对象,根据病情分为脓毒症组(20例)和严重脓毒症休克组(17例),另选18名健康人作为对照组。患者在起病入科时抽取外周血,采用酶联免疫吸附法(enzyme-linked immunoassay,ELISA)检测SAA、PD-1的浓度,流式细胞仪检测外周血T细胞亚群CD4^+、CD8^+、CD4^+/CD8^+的表达。结果与健康对照组比,脓毒症组、严重脓毒症及休克组外周血SAA浓度升高,PD-1浓度降低,CD4^+T细胞比率、CD4^+/CD8^+比值升高,CD8^+T细胞比率降低,差异均有统计学意义(P<0.05);与脓毒症组相比,严重脓毒症及休克组外周血SAA浓度更高,PD-1浓度更低,CD4^+T细胞比率、CD4^+/CD8^+比值更高,CD8^+T细胞比率更低,差异均有统计学意义(P<0.05)。结论外周血SAA、PD-1及CD4^+、CD8^+T细胞可作为腹腔感染致脓毒症患者病情的监测指标,且病情越重数值变化越大。

Objective The aim of this study is to investigate the expression of serum amyloid A protein （SAA）, programmed cell death- 1 （PD- 1）, CD4^＋ and CD8^＋ T cells in peripheral blood of patients with sepsis cruised by abdominal infections. Methods A total of 37 sepsis patients caused by abdominal infections in the intensive care unit （ICU） of a people＇s hospital of Lianyungang city from January 2014 to December 2015 were selected as research subjects, and divided into sepsis groups （20 cases） and severe sepsis or shock group （17 cases） according to severity of the condition. Another 18 healthy persons were selected as control group. Peripheral blood of patients were sampled when admitted into hospital. Enzyme-linked immunosorbent assay （ELISA） method was used to detect the concentration of SAA and PD- 1. Flow cytometry instrument was used to detect the expression of CD4＋and CD8^＋ T cells. Results Compared with the control group, in sepsis group and severe sepsis or shock group, concentration of SAA were increased, concentration of PD-1 were decreased, proportion of CD4＋ were increased, proportion of CD8^＋ was decreased, the ratio of CD,＋/CD8^＋ were increased, the differences were statistically significant （P〈0.05）; Compared with the sepsis group, in severe sepsis or shock group, concentration of SAA was higher, concentration of PD- 1 was lower, proportion of CD4＋ was higher, proportion of CD8^＋ was lower, ratio of CD4＋/CD8^＋ was higher, the differences were statistically significant （P〈0.05）. Conclusions The expression of SAA and PD- 1, and CD4＋, CD8^＋ T cells in peripheral blood can be used as the monitoring indexes of sepsis patients caused by abdominal infections. The severer the condition, the bigger the changes.