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大面积烧伤患者深部创面白细胞浸润反应的临床意义

Clinical significance of leukocyte infiltrative response in deep wound of patients with major burns.

作者信息

Peng Daizhi, Huang Wenhua, Ai Shenhai, Wang Shiliang

机构信息

Institute of Burn Research, Southwest Hospital, State Key Laboratory of Trauma, Burns and Combined Injury, The Third Military Medical University, Chongqing 400038, PR China.

出版信息

Burns. 2006 Dec;32(8):946-50. doi: 10.1016/j.burns.2006.03.003. Epub 2006 Aug 8.

Abstract

OBJECTIVE

To investigate the time course of infiltrated leukocytes and the subpopulations of infiltrated lymphocytes in deep wounds, and their relationship with injury severity in seriously burned patients.

METHODS

Six patients with major burns were enrolled in the study. Specimens were taken from deep partial-thickness burn wounds of all patients at 3 days, 1 week, 2 weeks and 3 weeks after burn. The appearance time and cellular components of infiltrated leukocyte zone in the burn wound were evaluated by histological and immunohistochemistry examination with lymphocyte monoclonal antibodies.

RESULTS

The infiltrated leukocyte zone of burn wound formed 1-2 weeks after burn. The more severe the degree of injury (including burn area, depth and combined injuries) was, the later the infiltrated leukocyte zone appeared. The infiltrated cells mainly consisted of polymorphonuclear leukocytes (PMN) during the early period after burn while macrophages and lymphocytes appeared later. There were some changes of the T lymphocyte subsets and their activation degree in the burn wound.

CONCLUSION

The changes of infiltrated leukocyte zone of wound following burns were closely related to the injury severity, and represented alteration of the anti-infection ability and immune rejection of local wound. These results provide important evidence for appropriate wound treatment and prolonging the survival of skin allograft.

摘要

目的

探讨严重烧伤患者深度创面浸润白细胞的时间进程、浸润淋巴细胞亚群及其与损伤严重程度的关系。

方法

选取6例重度烧伤患者作为研究对象。于烧伤后3天、1周、2周和3周,采集所有患者深Ⅱ度烧伤创面标本。采用组织学及淋巴细胞单克隆抗体免疫组化检查,评估烧伤创面浸润白细胞带的出现时间及细胞成分。

结果

烧伤创面浸润白细胞带于烧伤后1 - 2周形成。损伤程度(包括烧伤面积、深度及合并伤)越重,浸润白细胞带出现越晚。烧伤早期浸润细胞主要为多形核白细胞(PMN),后期出现巨噬细胞和淋巴细胞。烧伤创面T淋巴细胞亚群及其活化程度有一定变化。

结论

烧伤后创面浸润白细胞带的变化与损伤严重程度密切相关,反映了局部创面抗感染能力及免疫排斥反应的改变。这些结果为创面的合理处理及延长同种异体皮肤移植存活时间提供了重要依据。

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