老年人多器官功能衰竭前后系列免疫学变化

Serial immunologic changes before and after aged multiple organ failure

作者报道老年多器官功能衰竭(MOF)患者23例在衰竭前后T,B淋巴细胞及其亚群、免疫球蛋白及补体的变化.结果表明:MOF患者CD3_,CD_4,CD_8,CD_4/CD_8,CD_(20)及Sm IgG阳性细胞均比对照组少,随病情发展,死亡组CD_3,CD_4,CD_(20),Sm IgG细胞持续减少,而存活组CD_3,CD_4细胞呈上升趋势;死亡组血清IgG水平进行性下降,存活组仅轻度下降;患者组补体C_3明显低于对照组,随病情发展,C_3含量进一步减少,但死亡组与存活组间无差异(P>0.05).结果提示:免疫系统的功能状态与老年人MOF的预后有关.

Peripheral blood T and B lymphocytes, their subsets, serum immunoglobulins and serum complement component C3 were measured in 23 aged patients with multiple organ Mure (MOF). The results showed that CD3, CD4, CD8, CD20 and Sm IgG positive cells were significantly lower compared with those of normal control group. The ratio of CD4/CD8 droped. With the development of the illness, CD3, CD4, CD20 and Sm IgG cells in died group decreased progressively. By contrast, CD3 and CD4 cells in survival group tended to increase. Serum IgG and C3 levels in died group decreased as MOF development. These results indicates that the functional state of host immune system is closely related to the prognosis of aged MOF. Monitoring immune function, especially the changes of CD3 and CD4 cells, could be a significantly clinical index for determination of prognosis.