南方医科大学学报 ›› 2016, Vol. 36 ›› Issue (04): 544-.

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多发伤患者CD8+CD28-T细胞含量变化及其临床意义

麦惠强,许进,蓝先旗,陈树鑫   

  • 出版日期:2016-04-20 发布日期:2016-04-20

Changes of CD8 + CD28- T cell percentage in patients with multiple injuries and their clinical significance

  • Online:2016-04-20 Published:2016-04-20

摘要: 目的探讨多发伤患者CD8+CD28-T细胞含量变化及其与血小板(PLT)及D二聚体(D-D)的相关性。方法收集26例多发 伤患者作为观察对象,以31例单纯外伤患者(SI)及35名健康人作为对照组,采用流式细胞术检测首诊时外周血CD8+CD28-T细 胞及其胞内转化生长因子β1(TGF-β1)及白介素10(IL-10)百分含量,并比较3组PLT及D-D含量差异;分别在多发伤患者伤后 24、48及72 h重复检测上述5项指标并分析其相关性。结果(1)多发伤组患者CD8+CD28-T细胞、TGF-β1及IL-10均显著高于 单纯外伤(SI)组及健康组(P<0.05),但后两组之间无统计学差异;(2)单纯外伤(SI)组及多发伤组患者PLT及D-D均显著高于健 康组,3组间两两差异均具有显著性(P<0.05);(3)多发伤患者伤后48 h的CD8+CD28-T细胞、TGF-β1及IL-10均显著高于伤后 24 h(P<0.05),但伤后72 h上述3项指标均较伤后48 h及24 h显著下降(P<0.05),伤后24、48及72 h PLT及D-D均呈下降趋势, 任意两个时间点的变化均具有统计学差异(P<0.05);(4)CD8+CD28-T细胞、TGF-β1及IL-10这3者与PLT及D-D均呈显著正相 关性(均为r>0.70,均为P<0.05)。结论早期升高但伤后72 h回落是多发伤患者CD8+CD28-T细胞及其细胞因子的变化趋势,且 这三者与凝血功能密切相关。

Abstract: Objective To investigate the correlation of the changes in CD8 + CD28- T cell percentage with platelet (PLT) and D-dimer (D-D) levels in patients with multiple injuries (MI). Methods Twenty-six patients with MI, 31 with a single injury (SI group) and 26 healthy individuals were examined for peripheral blood CD8 +CD28- T cells and intracellular transformation growth factor-β1 (TGF-β1) and interleukin 10 (IL-10) contents using flow cytometry at 24, 48, and 72 h after the injuries. PLT and D-dimer levels were compared among the 3 groups. Results CD8 +CD28- T cells, TGF-β1 and IL-10 were significantly higher in MI group than in SI group and healthy control group (P<0.05) without significant differences between the latter 2 groups. The levels of PLT and D-D differed significantly among the 3 groups, the highest in MI group and the lowest in the control group. In MI group, CD8+CD28- T cells, TGF-β1 and IL-10 significantly increased at 48 h after the injury (P<0.05) but decreased significantly at 72 h (P<0.05) compared with the measurements at 24 h. The levels of PLT and D-D trended to decrease with time after the injuries and showed significant differences among the 3 groups at any of the 3 time points (P< 0.05). CD8+CD28- T cells, TGF-β1 and IL-10 were all positively correlated with the levels of PLT and D-D in MI patients (r>0.70, P<0.05 for all comparisons). Conclusion In MI patients, CD8+CD28- T cell percentage and their cytokines tend to increase early after the injury but decrease significantly at 72 h in close relation with the changes of the coagulation function following the injuries.