Jämsä J, Huotari V, Savolainen E-R, Syrjälä H, Ala-Kokko T
Department of Anaesthesiology, Division of Intensive Care Medicine, Oulu University Hospital, Medical Research Center Oulu, University of Oulu, Oulu, Finland.
NordLab Oulu, Oulu University Hospital, Medical Research Center Oulu, Department of Clinical Chemistry, University of Oulu, Oulu, Finland.
Acta Anaesthesiol Scand. 2015 Aug;59(7):881-91. doi: 10.1111/aas.12515. Epub 2015 Apr 13.
Leukocyte surface molecules may improve sepsis diagnostics. Our aim was to study whether monocyte and neutrophil CD11b and CD64 expression differs between patients with severe sepsis (including septic shock) and intensive care unit (ICU) controls, and also to investigate the expression kinetics in patient groups.
Monocyte and neutrophil CD11b and CD64 expression was analyzed in 27 patients with severe sepsis, 7 off-pump coronary artery bypass (OPCAB) patients, and 8 ICU patients without systemic inflammation in the beginning of the treatment using quantitative flow cytometry. Blood samples were collected within 48 h of the beginning of severe sepsis, at admission to the ICU for non-systemic inflammatory response syndrome patients, and on the day of surgery before the skin incision for OPCAB patients, and on 2 consecutive days for all patients. Ten healthy individuals served as controls.
Monocyte and neutrophil CD11b and neutrophil CD64 expression was higher in severe sepsis patients compared with the other groups (P < 0.05). In severe sepsis, the expression decreased over time (P < 0.05). In OPCAB patients, the monocyte and neutrophil CD64 expression increased after surgery (P < 0.05). Neutrophil CD64 expression had the highest and statistically significant area under curves (AUC) values for identification of severe sepsis during 3 consecutive days, the highest AUC being 0.990 on D0.
Neutrophil CD64 as well as neutrophil and monocyte CD11b expressions were highest in severe sepsis compared with non-infectious conditions, and thus analyses of their expression may be promising approach for sepsis diagnosis in ICU population.
白细胞表面分子可能改善脓毒症的诊断。我们的目的是研究严重脓毒症（包括脓毒性休克）患者与重症监护病房（ICU）对照患者之间单核细胞和中性粒细胞CD11b及CD64的表达是否存在差异，并调查患者组中的表达动力学。
使用定量流式细胞术分析了27例严重脓毒症患者、7例非体外循环冠状动脉搭桥术（OPCAB）患者和8例治疗开始时无全身炎症的ICU患者的单核细胞和中性粒细胞CD11b及CD64表达。在严重脓毒症开始后的48小时内、非全身炎症反应综合征患者入住ICU时、OPCAB患者皮肤切开术前的手术当天以及所有患者连续2天采集血样。10名健康个体作为对照。
与其他组相比，严重脓毒症患者的单核细胞和中性粒细胞CD11b以及中性粒细胞CD64表达更高（P<0.05）。在严重脓毒症中，表达随时间下降（P<0.05）。在OPCAB患者中，手术后单核细胞和中性粒细胞CD64表达增加（P<0.05）。中性粒细胞CD64表达在连续3天内用于识别严重脓毒症时具有最高且具有统计学意义的曲线下面积（AUC）值，最高AUC在第0天为0.990。
与非感染性情况相比，严重脓毒症中中性粒细胞CD64以及中性粒细胞和单核细胞CD11b表达最高，因此分析它们的表达可能是ICU人群中脓毒症诊断的有前景的方法。
