低剂量氢化可的松治疗感染性休克时对外周血T淋巴细胞凋亡的影响及机制

Influence and mechanism of low dose hydrocortisone on peripheral blood T lymphocyte apoptosis in treatment septic shock

目的分析低剂量氢化可的松治疗感染性休克时对外周血T淋巴细胞凋亡的影响及机制。方法依据随机数字方法将60例感染性休克患者分成治疗组30例和对照组30例,其中,治疗组给予低剂量氢化可的松治疗;同时,另外选择同期30例脓毒血症患者作为脓毒血症组和30例健康体检者作为健康体检组。采集每组研究对象的外周血,选择流式细胞仪和Annexin V法对研究对象的T淋巴细胞亚群凋亡情况进行检测,选择酶增敏免疫测定法对研究对象的白细胞介素-10(IL-10)进行测定,观察分析检测结果。结果治疗组患者治疗后的外周血CD4+亚群淋巴细胞的凋亡显著高于对照组(P<0.05),治疗组与对照组的CD8+亚群凋亡比较差异无统计学意义。治疗组、对照组、脓毒血症组的IL-10浓度显著高于健康体检组(P<0.05),治疗组治疗后的IL-10水平显著高于对照组(P<0.05)。结论低剂量氢化可的松治疗感染性休克会显著增加血IL-10浓度水平和外周血CD4+T淋巴细胞凋亡,而IL-10水平上升则是诱导外周血CD4+T淋巴细胞凋亡增多的主要原因之一。

Objective To analyze the influence and mechanism of low dose hydrocortisone on peripheral blood T lymphocyte apoptosis in treatment septic shock.Methods according to random number method,60patients with septic shock was divided into30cases in the treatment group and30cases in the control group,among them,the treatment group was treated with low-dose hydrocortisone;in addition,30patients with sepsis during the same period were selected as the sepsis group and30healthy subjects as the healthy group.peripheral blood of each group was collected,Select the flow cytometry and Annexin V method of T lymphocyte subsets in the study of apoptosis,the interleukin-10(IL-10)of the subjects was determined by the enzyme sensitization immunoassay.The test results was observed and analyzed.Results After treatment,peripheral blood CD4+subgroup lymphocyte apoptosis in treatment group was significantly higher than control group(P<0.05),the CD8+subgroup apoptosis between the treatment group and the control group was no significant difference.the levels of IL-10in the treatment group,the control group and the sepsis group were significantly higher than that in the health group(P<0.05).After treatment,the level of IL-10in the treatment group was significantly higher than that in the control group(P<0.05).Conclusion Low dose hydrocortisone treatment of septic shock can significantly increase blood IL-10level and peripheral blood CD4+T lymphocyte apoptosis,the increase of IL-10level is one of the main reasons to induce apoptosis of CD4+T lymphocytes in peripheral blood.