合并腹部创伤的严重多发伤患者外周血MIP-1α的表达及意义

Expression and clinical significance of macrophageinflammatory protein-1alpha in patients with severe injury involved abdominal trauma

目的 探讨严重腹部创伤后炎症反应的分子机制。方法 损伤程度评分 (injuryseverityscore ,ISS)≥ 16分的创伤患者 2 8例 ,A组为无腹部创伤组共 15例 ,B组为合并腹部创伤组共 13例 ,健康对照组 10例。用酶联免疫吸附法 (ELISA)检测伤后不同时间外周血浆MIP 1α的表达水平 ,用Ficoll -Hypaque梯度离心法和粘附法分离纯化单核细胞 ,流式细胞术分析单核细胞CD86和CD64的表达情况。结果 A、B二组创伤患者外周血单核细胞CD64表达均明显增加 ,CD86表达明显降低 ,创伤患者血浆MIP -1α表达水平明显升高 ,于第 1日最明显 ,B组异常表达持续时间更长 ,组间比较差异显著。结论 创伤后单核细胞功能的变化与创伤后不同功能单核细胞亚群比例的变化有关 。

Objective To investigate the molecular mechanism of post-traumatic inflammation in patients with injury complicated severe abdominal trauma.Methods Twenty-eight severe injured patients〔injury severity score(ISS)≥16〕were divided into two groups.Group A included 15 cases with severe injury non-complicated any abdominal trauma and group B was consisted of 13 cases with injury complicated severe abdominal trauma and 10 healthy volunteers served as controls.Peripheral blood mononuclear cells were separated by Ficoll-Hypaque density gradient centrifugation.Flow cytometry was performed to analyze the expression of CD86 and CD64.Enzyme linked immunosorbentassay (ELISA) was used to detect the macrophage inflammatory protein-1α(MIP-1α) contents in plasma.Results The expression of CD64 was increased markedly in two groups.The expression of CD86 was decreased obviously in two groups after trauma.However,the change recovered on the 3rd day after trauma in group A but not in group B.There was obvious difference between two groups.Plasma MIP-1α levels were evidently elevated in two groups and peaked on the first day,then declined on the third day,recovered on the fifth day after trauma in group A but not in group B.There was obvious difference between two groups.Conclusions The changes in monocytic function after trauma appear to be closely associated with the changes in proportion of monocytic subpopulation and are obvious in patients with severe injury complicated abdominal trauma.The susceptibility to infectious complicaton is increased in patients with severe injury complicated abdominal trauma.