细菌性脓毒症患者外周血Th1 Th2细胞免疫应答检测及意义分析

Detection and significance of Th1 and Th2 cell immune response in peripheral blood of patients with bacterial sepsis

目的 观察细菌性脓毒症患者外周血Th1、Th2细胞及其免疫应答产物与病情程度的关系.方法 选择2018年1月至12月南通大学附属医院ICU收治的细菌性脓毒症患者50例为脓毒症观察组,50例非脓毒症患者作为非脓毒症对照组,两组均于入ICU即刻行APACHEⅡ评分、Th1细胞及其免疫应答产物(CD4+、CD3+、IFN-γ)和Th2细胞及其免疫应答产物(IL-10、CD8+、IL-4)检测,观察上述指标差异,分析脓毒症观察组的Th1/Th2比值与APACHEⅡ评分之间的相关性.结果 脓毒症观察组外周血Th1细胞(%:9.67±1.0 vs.14.85 ±1.48)和CD4+(%:54.48±2.81 vs.80.18±3.41)低于非脓毒症对照组,脓毒症观察组CD3+(%:56.88±3.09 vs.34.19±2.71)和IFN-γ(%:64.84±3.77 vs.54.79±3.09)高于非脓毒症对照组(P<0.05);脓毒症观察组的Th2(%:17.98±1.64 vs.6.85±1.01)、CD8+(%:67.18±3.21 vs.48.93±2.87)、IL-4(%:63.29±3.6 vs.54.19±3.11)及IL-10(%:72.09±4.13 vs.58.62±3.61)均高于非脓毒症对照组(P<0.05);脓毒症观察组的Th1/Th2比值(0.53±0.16 vs.2.67±0.54)低于非脓毒症对照组(P<0.05).脓毒症观察组的Th1/Th2比值与APACHEⅡ评分负相关(r=-0.887,P=0.013).结论 细菌性脓毒症患者均存在明显的Th1/Th2比值失衡和免疫应答失衡,且Th1/Th2比值失衡程度与病情发展密切相关,外周血Th1、Th2细胞及其免疫应答产物检测在细菌性脓毒症病情判断中具有重要的意义.

Objective Thl and Th2 cells and their immune response products in peripheral blood of patients with bacterial sepsis were detected,and the relationship between Thl and Th2 cells and the severity of bacterial sepsis was observed.Methods Fifty cases of bacterial sepsis(admitted to ICU from January to December 2018)were taken as sepsis observation group and 50 cases of non-sepsis patients admitted to ICU in the same period matched with baseline data of sepsis observation group as non—sepsis control group.APACHE II score,Thl cells and their immune response products(GD4+,CD3+,IFN-γ)and Th2 cells and their immune response products(IL-10,CD8+,IL-4)were immediately performed in both groups,and the differences of the above indicators were observed and the correlation between Thl/Th2 ratio and APACHE II score in sepsis observation group was analyzed.Results The observation of peripheral blood Thl cells and their immune response products(CD4+,CD3+,IFN-γ)showed that the peripheral blood Thl(9.67±1.0)%and CD4+(54.48±2.81)%in the sepsis observation group were lower than those in the non-sepsis control group(14.85±1.48)%,80.18土3.41)%;CD3+(56.88±3.09)%,IFN-γ(64.84±3.77)%were higher than those in the non-sepsis control group(34.19±2.71)%,(54.79±3.09)%(P<0.05);while the Th2 cells(17.98±1.64)%,CD8+(67.18±3.21)%,1L-4(63.29±3.6)%,IL-10(72.09±4.13)%in the sepsis observation group were higher than those in the non-sepsis control group(6.85±1.01)%,(48.93±2.87)%,(54.19±3.11)%,(58.62±3.61)%(P<0.05).The ratio of Thl/Th2(0.53±0.16)in sepsis observation group was lower than that in non-sepsis control group(2.67±0.54)(P<0.05).Th1/Th2 ratio in sepsis observation group was negatively correlated with APACHE II score(r=-0.887,P=0.013).Conclusion The imbalance of Th1/Th2 ratio and immune response in patients with bacterial sepsis is obvious,and the imbalance degree of Th1/Th2 ratio is closely related to the development of the disease.The detection of Th1,Th2 cells and their immune response products in peripheral blood is of great significance in judging the condition of bacterial sepsis.