多器官功能障碍综合征患者T淋巴细胞亚群的临床意义

The clinical significance of T-lymphocyte subsets in patients with mutiple organ dysfunction syndrome

目的:观察多器官功能障碍综合征(MODS)患者T淋巴细胞亚群变化并探讨其临床意义。方法:以MODS患者40例(年龄40岁～86岁)和非MODS患者40例(年龄27岁～82岁)为研究对象,采用流式细胞仪FACSCalibuv(美国BD公司)定量测定外周血CD3+T细胞(CD3阳性淋巴细胞)、CD4+T细胞(CD4阳性淋巴细胞)和CD8+T细胞(CD8阳性淋巴细胞)的百分比及CD4+T/CD8+T值。结果:相比非MODS患者,MODS组CD3+T、CD4+T、CD8+T的百分比及CD4+T/CD8+T值均降低(P【0.01)。与MODS存活组相比,死亡组患者CD4+T的百分比和CD4+T/CD8+T值降低(P【0.05或P【0.01),而CD3+T和CD8+T百分比的差异没有统计学意义(P】0.05)。结论:MODS患者存在细胞免疫功能损害,死亡组MODS患者损害更为严重。外周血T淋巴细胞亚群检测对MODS患者免疫功能评价和判断预后具有重要的临床意义。

Objective:To observe the changes and evaluate the the clinical significance of T-lymphocyte subsets in patients with multiple organ dysfunction syndrome(MODS).Method:40 MODS patients aged 40 to 86 were included in this study.In addition 40 non-MODS patients aged 27 to 82 were included as control group.The percentage of CD3+T cells,CD4+T cells and CD8+T cells were detected by the flow cytometry FACS Calibuv (BD Company,American) and the ratio of CD4+T/CD8+T was counted. Result:Compared to non-MODS patients,patients with MODS had a significant decrease of percentage of CD3+T cells,CD4+T cells and CD8+T cells as well as CD4+T/CD8+T ratio (P<0.01). Compared to survival patients with MODS, patients who died with MODS had a significant decrease of percentage of CD4+T cells and CD4+T/CD8+T ratio (P<0.05或P<0.01).The percentage of CD3+T cells and CD8+T had no statistical difference between two groups(P>0.05).Conclusion:There are cellular immune dysfunction in patients with MODS,especially in non-survival group. Detection of T-lymphocyte subsets in peripheral blood in patients with MODS has important clinical significance in evaluation of immune function and judgement of prognosis.