右美托咪定对重度烧伤患者外周血Th17细胞和Treg细胞数量的影响

Effect of Dexmedetomidine on the Number of Th17 Cells and Treg Cells in Peripheral Blood of Patients with Severe Burns

目的:评价早期使用右美托咪定对重度烧伤患者外周血辅助性T细胞17(Th17)及调节性T细胞(Treg)细胞数量的影响。方法:选择40例烧伤面积≥30%总体表面积患者,随机分为两组(n=20):右美托咪定组(A组)、烧伤对照组(B组)。另设立健康志愿者组(C组,n=20)。入院即给与A组1μg·kg-1·h-1的速率泵注右美托咪定48 h,其余两组患者不给予右美托咪定泵注,其余治疗均相同。患者分别于入院即刻(T1)、伤后24 h(T2)、伤后7 d(T3)时抽取外周静脉血,共3次;C组仅采血1次。分别利用流式细胞术检测Th17细胞以及Treg细胞。结果:T2、T3时间点A组的VAS疼痛评分低于B组; T1、T2时间点A、B组外周血中Th17细胞百分比均高于C组(P<0.05);A组T3时间点外周血中Th17细胞比例小于T1、T2时间点(P<0.05),但高于B组T3时间点(P<0.05); T1、T2时间点A、B组外周血中Treg细胞比例均低于C组(P<0.05),T3时间点A组外周血中Treg细胞比例高于B组(P<0.05)。结论:早期使用右美托咪定能减轻大面积烧伤患者烧伤后引起的细胞免疫抑制,保持机体的免疫能力。

Objective:To evaluate the effect of early dexmedetomidine on the number of Th17 cells and Treg cells in peripheral blood of patients with severe burns.Methods:Forty patients with burns≥30% of total surface area were randomly divided into two groups(n=20):dexmedetomidine group(group A)and burn control group(group B).A healthy volunteer group was also established(group C,n=20).On admission,dexmedetomidine was administered to the patients of group A at a rate of 1μg·kg-1·h-1 for 48 h.The remaining treatments were the same in groups A and B.Peripheral venous blood samples were taken from the patients in groups A and B immediately at admission(T1),24 hours after injury(T2)and 7 days after injury(T3).The blood samples were collected only once in group C.Th17 cells and Treg cells were detected by flow cytometry,respectively.Results:The VAS pain scores of group A were lower than those of group B at T2 and T3.The percentages of Th17 cells for groups A and B were higher than that for group C at T1 and T2(P<0.05).The percentage of Th17 cells for the group A at T3 was lower than those at T1 and T2(P<0.05),while higher than that for the group B at T3(P<0.05).The percentages of Treg cells for groups A and B were lower than that for group C(P<0.05).The percentage of Treg cells for the group A was higher than that for the group B at T3(P<0.05).Conclusion:Early use of dexmedetomidine can alleviate the cellular immunosuppression caused by burns in patients with extensive burns and maintain the body’s immunity.