摘要
目的:研究免疫失衡在重症急性胰腺炎患者继发全身感染中的作用。方法:55例重症急性胰腺炎患者分为确诊全身感染组(A组)和可疑全身感染或无全身感染组(B组)。检测入院第1、3、7、10天的外周血人白细胞DR抗原(HLA-DR),T辅助淋巴细胞1/2(Th1/Th2)比值,调节性T细胞(Treg)水平。统计患者住外科重症监护病房(SICU)的天数及28d病死率。结果:55例患者平均住SICU(9.82±4.32)d,住院(24.72±10.35)d,28d病死率为9.09%。A组病死率及住SICU天数较B组增加。A组各时间点HLA-DR和Th1/Th2均低于B组。各时点Treg值A组均高于B组。重症急性胰腺炎患者住SICU天数、28d病死率与HLA-DR呈负相关。各时间点Th1/Th2值与Treg呈负相关。各时间点累及脏器数与HLA-DR呈负相关,与病死率呈正相关。结论:全身感染患者早期即出现抗原呈递作用受阻碍,免疫失衡,增加了机体对内、外源性感染的易感性,机体不能有效清除病原体,延长了住SICU的天数,增加了病死率。
Objective： To study the effect of immune imbalance in secondary systemic infection in patients with severe acute pancreatitis. Methods： Fifty-five patients with severe acute pancreatitis were divided into secondary systemic infection group （A group） and suspected systemic infection or without systemic infection group （B group）. The level of human leukocyte antigen DR （HLA-DR）, T helper lymphocyte 1/2 （Th1/Th2） ratio, the level of regulation of T cell （Treg） in peripheral blood were detected on the 1st , 3nd , 7th and 10th day. The mortality rate at 28 days and the length of stay in surgical intensive care unit （SICU） were recorded. Results： In 55 patients, the length of SICU stay was （9.82±4.32） days, the length of hospital stay was （24.72±10.35）days, the mortality rate at 28 days was 9.09% （5/55）. The mortality rate and the length of SICU stay were higher in A group than those of B group. At each time point, values of HLA-DR and Th1/Th2 were significantly lower in A group than those of B group. Values of Treg at each time point were higher in A group than those of B group. The length of SICU stay and the mortality rate at 28 days were negatively correlated with value of HLA-DR in patients with severe acute pancreatitis. Values of Th1/Th2 at each time point were negatively correlated with values of Treg. The number of involved organs was negatively related to HLA-DR, and was positively correlated with the mortality rate. Conclusion： Patients with systemic infection occurred early antigen presenting function hindrance and immune imbalance, which increased endogenous and exogenous body susceptibility to infection. The body can not effectively remove pathogens, appearing systemic infection, prolonged SICU stay days and increased mortality rate.
出处
《天津医药》
CAS
北大核心
2012年第7期672-674,共3页
Tianjin Medical Journal
基金
国家重点基础研究发展(973)计划(项目编号:2009CB522703)
作者简介
通讯作者:傅强,E-mail:fq@medmail.com.cn.
