Xia Chenyun, Wang Mi, Liang Qi, Yun Ling'an, Kang Housheng, Fan Lei, Wang Dongsheng, Zhang Guoyuan
Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China.
Department of Nephropathy, People's Hospital of Peking University, Beijing 100044, P.R. China.
Exp Ther Med. 2014 Jan;7(1):137-140. doi: 10.3892/etm.2013.1356. Epub 2013 Oct 22.
The aim of this study was to investigate changes in human leukocyte antigen (HLA)-DR expression of peripheral blood mononuclear cells (MNCs) in patients with acute organophosphorus pesticide poisoning (AOPP). HLA-DR antigen expression of peripheral blood MNCs was examined in 75 patients with AOPP, including 36 patients without multiple organ dysfunction syndrome (non-MODS) and 39 patients with multiple organ dysfunction syndrome (MODS), as well as in 30 healthy individuals using flow cytometry assay. The associations between HLA-DR antigen expression and certain parameters were analyzed, including acute physiology and chronic health evaluation II (APACHE II) score, serum cholinesterase (ChE) activity, cardiac troponin I (cTnI), cardiac enzymes, and liver and kidney function. The mean fluorescence intensity (MCF) of HLA-DR expression in the AOPP group (21.59±5.36) was significantly lower than that in the control group (27.85±4.86) (P<0.001). The MCF in the MODS group (18.17±4.23) was lower than that in the non-MODS group (25.15±6.15). In addition, the MCF of the deceased patients (15.29±3.97) was lower than that of the surviving patients (22.34±2.76) (P<0.001). The MCF of patients with AOPP and MODS was positively correlated with serum ChE (P<0.01) and negatively correlated with the APACHE II score, creatine kinase isoenzyme, cTnI, lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen and serum creatinine (P<0.05). In conclusion, HLA-DR expression in patients with AOPP was significantly decreased compared with that in healthy individuals; HLA-DR expression may therefore be a good indicator for evaluating AOPP, MODS disease severity, immune function, efficacy of prognosis and prognosis. Examination of HLA-DR antigen expression may be of crucial clinical value.
本研究旨在探讨急性有机磷农药中毒（AOPP）患者外周血单个核细胞（MNCs）人类白细胞抗原（HLA）-DR表达的变化。采用流式细胞术检测了75例AOPP患者外周血MNCs的HLA-DR抗原表达，其中包括36例无多器官功能障碍综合征（非MODS）的患者和39例有多器官功能障碍综合征（MODS）的患者，以及30名健康个体。分析了HLA-DR抗原表达与某些参数之间的相关性，这些参数包括急性生理与慢性健康状况评分系统II（APACHE II）评分、血清胆碱酯酶（ChE）活性、心肌肌钙蛋白I（cTnI）、心肌酶以及肝肾功能。AOPP组HLA-DR表达的平均荧光强度（MCF）（21.59±5.36）显著低于对照组（27.85±4.86）（P<0.001）。MODS组的MCF（18.17±4.23）低于非MODS组（25.15±6.15）。此外，死亡患者的MCF（15.29±3.97）低于存活患者（22.34±2.76）（P<0.001）。AOPP合并MODS患者的MCF与血清ChE呈正相关（P<0.01），与APACHE II评分、肌酸激酶同工酶、cTnI、乳酸脱氢酶、谷丙转氨酶、谷草转氨酶、血尿素氮和血清肌酐呈负相关（P<0.05）。总之，与健康个体相比，AOPP患者的HLA-DR表达显著降低；因此，HLA-DR表达可能是评估AOPP、MODS疾病严重程度、免疫功能、预后疗效及预后的良好指标。检测HLA-DR抗原表达可能具有至关重要的临床价值。
