重度烧伤后血清丙二醛和一氧化氮及超氧化物歧化酶水平与患者免疫功能的相关性

Correlations of serum malondialdehyde,nitric oxide and superoxide dismutase with immune function of patients after severe burn

目的观察重度烧伤患者血清丙二醛(malondialdehyde,MDA)、一氧化氮(nitric oxide,NO)、超氧化物歧化酶(superoxide dismutase,SOD)水平变化,探讨其与患者免疫功能(CD4^(+)/CD8^(+)比值)的关系。方法72例重度烧伤患者于烧伤后第1、3、7天采用比色法检测血清MDA、NO、SOD水平,应用流式细胞仪检测CD4^(+)、CD8^(+)T淋巴细胞水平,计算CD4^(+)/CD8^(+)比值;采用Pearson相关法分析重度烧伤患者血清MDA、NO、SOD水平与CD4^(+)/CD8^(+)比值的相关性;采用多元线性回归分析重度烧伤患者CD4^(+)/CD8^(+)比值的影响因素。结果重度烧伤患者烧伤后第1、3、7天血清MDA[(4.35±1.15)、(5.03±1.27)、(5.34±1.34)μmol/L]、NO[(32.65±6.15)、(38.25±7.02)、(42.35±7.65)μmol/L]水平均依次升高(P<0.05),SOD水平[(80.35±6.65)、(75.28±5.58)、(70.58±6.25)u/mL]及CD4^(+)/CD8^(+)比值(1.22±0.35、1.05±0.41、0.97±0.25)均依次降低(P<0.05)。重度烧伤患者血清MDA、NO水平与CD4^(+)/CD8^(+)比值均呈负相关(r=-0.940,P<0.001;r=-0.302,P<0.001),SOD水平与CD4^(+)/CD8^(+)比值呈正相关(r=0.322,P<0.001)。血清MDA(β=-0.393,95%CI:-0.408~-0.379,P<0.001)、NO(β=-0.024,95%CI:-0.032~-0.017,P<0.001)、SOD(β=0.017,95%CI:0.011~0.023,P<0.001)水平是重度烧伤患者CD4^(+)/CD8^(+)比值的影响因素。结论重度烧伤患者免疫功能随血清MDA、NO水平升高而降低,随血清SOD水平降低而降低,血清MDA、NO高表达及SOD低表达的重度烧伤患者免疫功能较差。

Objective To observe the changes of serum malondialdehyde(MDA),nitric oxide(NO)and superoxide dismutase(SOD)levels in patients with severe burn,and to explore their relationship with immune function(CD4^(+)/CD8^(+)ratio).Methods Seventy-two patients with severe burn were detected the serum levels of MDA,NO and SOD by colorimetry,and CD4^(+)and CD8^(+)T cells were detected by flow cytometry on the 1st,3rd and 7th days after burn,and the ratio of CD4^(+)/CD8^(+)was calculated.The correlations of the serum levels of MDA,NO and SOD with CD4^(+)/CD8^(+)ratio in severe burn patients were analyzed by Pearson correlation method,and the influencing factors of CD4^(+)/CD8^(+)ratio were analyzed by multiple linear regression.Results The serum levels of MDA[(4.35±1.15),(5.03±1.27),(5.34±1.34)μmol/L]and NO[(32.65±6.15),(38.25±7.02),(42.35±7.65)μmol/L]increased gradually in turn on the 1st,3rd and 7th days after burn(P<0.05),and SOD levels[(80.35±6.65),(75.28±5.58),(70.58±6.25)u/mL]and CD4^(+)/CD8^(+)ratios(1.22±0.35,1.05±0.41,0.97±0.25)decreased gradually in turn(P<0.05).The serum levels of MDA and NO were negatively correlated with CD4^(+)/CD8^(+)ratio in patients with severe burn(r=-0.940,P<0.001;r=-0.302,P<0.001),and the SOD level was positively correlated with CD4^(+)/CD8^(+)ratio(r=0.322,P<0.001).Serum MDA(β=-0.393,95%CI:-0.408to-0.379,P<0.001),NO(β=-0.024,95%CI:-0.032to-0.017,P<0.001)and SOD(β=0.017,95%CI:0.011-0.023,P<0.001)were the influencing factors of CD4^(+)/CD8^(+)ratio in patients with severe burn.Conclusions The immune function decreases with the increase of serum MDA and NO levels and the decrease of serum SOD level in patients with severe burn.The severe burn patients with highly expressed serum MDA and NO levels and lowly expressed SOD level usually have a poor immune function.