Fingerle-Rowson G, Auers J, Kreuzer E, Fraunberger P, Blumenstein M, Ziegler-Heitbrock L H
Department of Internal Medicine I, Klinikum Grosshadern, University of Muenchen, FRG.
Inflammation. 1998 Aug;22(4):367-79. doi: 10.1023/a:1022316815196.
We have asked whether critically ill cardiac valve surgery patients identified by a high APACHE II score exhibit an increase in the number of proinflammatory CD14+CD16+ monocytes. A group of 12 patients was studied over a period of 5 days post cardiac valve surgery for changes in blood monocyte populations. Patients were selected on day 1 post surgery to either be in good clinical condition (APACHE II Score of < or = 14; N = 9) or to be critically ill (APACHE II score of > or = 24; N = 3). The < or = 14 patients had an uneventful course and could leave the ICU after 2-3 days. Among the > or = 24 patients two showed a decrease of the score to < or = 14 within the 5 days of observation and they could leave the ICU thereafter. One > or = 24 patient (patient #2) had a persistently high score and finally died on day 28. Analysis of blood monocytes on day 1 post surgery revealed that the < or = 14 patients had normal values of CD14+CD16+ monocytes (44 +/- 9/microliter). By contrast the > or = 24 patients had increased values of these cells with 243 +/- 106 cells per microliter on day 1. The numbers of CD14+CD16+ monocytes returned to the control range over the 5 days of observation in 2 of the > or = 24 patients concomitant with the improvement of the APACHE II score. CD14+CD16+ monocytes remained, however, at a high level in patient #2, the patient with persistently high APACHE II score.
我们探讨了通过高APACHE II评分识别出的重症心脏瓣膜手术患者促炎CD14+CD16+单核细胞数量是否增加。对一组12例患者在心脏瓣膜手术后5天内进行研究，观察血液单核细胞群体的变化。术后第1天选择患者，使其临床状况良好（APACHE II评分≤14；N = 9）或病情严重（APACHE II评分≥24；N = 3）。APACHE II评分≤14的患者病程顺利，术后2 - 3天即可离开重症监护病房（ICU）。在APACHE II评分≥24的患者中，有2例在观察的5天内评分降至≤14，随后也离开了ICU。1例APACHE II评分≥24的患者（患者#2）评分持续居高不下，最终在第28天死亡。术后第1天对血液单核细胞的分析显示，APACHE II评分≤14的患者CD14+CD16+单核细胞值正常（44±9/微升）。相比之下，APACHE II评分≥24的患者这些细胞的值升高，术后第1天为243±106个/微升。在APACHE II评分≥24的2例患者中，随着APACHE II评分的改善，CD14+CD16+单核细胞数量在观察的5天内恢复到对照范围。然而，在患者#2（APACHE II评分持续居高不下的患者）中，CD14+CD16+单核细胞数量仍维持在较高水平。
