创伤早期患者外周血树突状细胞的变化及临床意义

The change and clinical signification of peripheral blood dendritic cells in the early stage of traumatic patients

目的 探讨创伤后早期患者外周血树突状细胞 (DC)变化及临床意义。方法 分离创伤患者 ( 2 7例 ,创伤组 )和健康人 ( 12例 ,对照组 )外周树突状细胞 ;通过流式细胞仪检测各组的DC数量 (CMRF 44标记法 )及DC表面HLA DR、CD80、CD86表达水平以及DC诱导的T细胞反应性增殖。检测各组外周血上清中白细胞介素 6(IL 6)、IL 10的浓度。结果 创伤组DC细胞数( 7.9± 3 .2 )× 10 6/L明显低于对照组DC ( 14 .9± 5 .1)× 10 6/L(P <0 .0 1)。创伤组DC表面HLA DR及CD80、CD86的表达水平与对照组相比明显下调 (P <0 .0 1)。DC诱导的T细胞增殖能力对照组明显强于创伤组 (P <0 .0 1)。在创伤组中血清IL 6、IL 10的浓度 ( 2 .42± 0 .3 3 ) μg/L和( 1.49± 0 .2 7) μg/L显著升高 ,与对照组比较差异有非常显著性 (P <0 .0 1)。 结论 创伤早期患者外周血DC数量少 ,功能低下 ,与创伤后的免疫功能低下关系密切。

Objective To explore the change and clinical signification of peripheral blood dendritic cells of traumatic patients in the early stage.Methods DC were purified from peripheral blood of health volunteers (control group,10 cases) and traumatic patients (trauma group,27 cases).The number of DC and the expression levels of HLA-DR and CD80,CD86 on DC were detected by CMRF-44 mAb labeling and flow cytometer.The supernatants of every group were collected and the concentration of IL-6 and IL-10 were measured by ELISA.The capacity of DCs-induced proliferation of T-cells wastested in a mixed leukocyte reaction (MLR).Results The DC counts in trauma groups [(7.9±3.2)×106/L] were obviously lower than in control groups [(14.9±5.1×)106/L,P<0.01)].The expression level of HLA-DR and CD80,CD86 of DC in trauma group were obviously down-regulated as compared with those in control group (P<0.01).There was significant difference in the concentrations of IL-6 and IL-10 between trauma group [(2.42±0.33) μg/L and (1.49±0.27) μg/L] respectively and control group (P< 0.01).The proliferation of T-cells induced by DC was obviously reduced in trauma group as compared with control group.Conclusion The number of DC was decreased and the function of DC was inadequacy in traumatic patients,which might be closely correlated with immunosuppression after trauma.