Li Zhi-tao, Gong Yu-qiang, Wang Sheng-biao, Jin Sheng-wei, Sun Lai-fang, Wang Zheng, Hu Xue-zhen, Chen Ying, Xu Jun-nan, Qi Yan-hong, Lian Qing-quan
Emergency Intensive Care Unit, Second Hospital of Wenzhou Medical University, Wenzhou 325000, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2010 Oct;30(10):2249-51.
To observe the dynamic changes of CD3+, CD4+, and CD8+ T lymphocytes in the peripheral blood of patients with sepsis and discuss the clinical significance.
Sixty-four patients admitted in the Emergency Center and Emergency Intensive Care Unit of the Second Hospital of Wenzhou Medical University between August, 2007 and July, 2009 were enrolled in this study. CD3+, CD4+, and CD8+ T lymphocytes in the peripheral blood were detected by flow cytometry on days 1, 7 and 14 after admission, and the results were compared between the patients with improvement of the condition and those without improvement, with 20 healthy subjects as the control group.
On day 1 after admission, CD3+ and CD4+ T lymphocytes and CD4+/CD8+ T cell ratio were obviously lower in the 2 groups of patients with sepsis than in the control group (P<0.05), but no significant difference was found in CD8+ T lymphocytes. The sepsis patients with clinical improvement showed significant higher CD3+ and CD4+ T lymphocyte percentages and CD4+/CD8+ T cell ratio than those without improvement on day 1. In the patients with clinical improvement, CD3+ and CD4+T lymphocytes and CD4+/CD8+ T cell ratio increased gradually with time and till day 14, they were comparable with the control levels; in the patients without improvement, CD3+ and CD4+ T lymphocytes and CD4+/CD8+ T cell ratio showed no obvious alterations in the course of observation.
Immune imbalance occurs in patients with sepsis represented by lowered CD3+ and CD4+T lymphocyte percentages and CD4+/CD8+ T cell ratio in relation to the severity of the condition. CD3+ and CD4+ T lymphocytes and CD4+/CD8+ T cell ratio can be used as the indicators for assessing the severity of sepsis.
观察脓毒症患者外周血中CD3⁺、CD4⁺及CD8⁺T淋巴细胞的动态变化并探讨其临床意义。
选取2007年8月至2009年7月在温州医科大学附属第二医院急诊中心及急诊重症监护病房收治的64例患者纳入本研究。于入院第1天、第7天和第14天采用流式细胞术检测外周血中CD3⁺、CD4⁺及CD8⁺T淋巴细胞，并将病情好转患者与未好转患者的检测结果进行比较，另选20例健康受试者作为对照组。
入院第1天，两组脓毒症患者的CD3⁺和CD4⁺T淋巴细胞及CD4⁺/CD8⁺T细胞比值均明显低于对照组（P<0.05），但CD8⁺T淋巴细胞差异无统计学意义。临床好转的脓毒症患者在第1天时CD3⁺和CD4⁺T淋巴细胞百分比及CD4⁺/CD8⁺T细胞比值显著高于未好转患者。临床好转患者中，CD3⁺和CD4⁺T淋巴细胞及CD4⁺/CD8⁺T细胞比值随时间逐渐升高，至第14天时与对照组水平相当；未好转患者在观察期间CD3⁺和CD4⁺T淋巴细胞及CD4⁺/CD8⁺T细胞比值无明显变化。
脓毒症患者存在免疫失衡，表现为CD3⁺和CD4⁺T淋巴细胞百分比及CD4⁺/CD8⁺T细胞比值降低，且与病情严重程度相关。CD3⁺和CD4⁺T淋巴细胞及CD4⁺/CD8⁺T细胞比值可作为评估脓毒症严重程度的指标。
