Lymphocyte subset numbers depend on the bacterial origin of sepsis
Lymphocyte subset numbers depend on the bacterial origin of sepsis
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DOI：
10.1046/j.1469-0691.2003.00518.x
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发表时间：
2003-03-01
影响因子：
14.2
通讯作者：
Beran, O
中科院分区：
文献类型：
--
作者：
Holub, M;Klucková, Z;Beran, O
目的探讨脓毒症患者外周血淋巴细胞亚群的数量变化及其临床意义方法对32例非手术脓毒症患者入院14 d内外周血淋巴细胞亚群进行计数，并与34例健康对照者进行比较。结果脓毒症患者CD 4（+）、CD 8（+）和总T淋巴细胞均较正常值显著下降（P < 0.05），但仅CD 4（+）T淋巴细胞和自然杀伤（NK）细胞的下降持续时间分别为3d和7 d。此外，CD 3（+）DR+淋巴细胞的数量在第14天显著升高。这些改变与脓毒症的严重程度之间没有相关性。革兰氏阳性脓毒症（n = 10），主要是由于肺炎链球菌和金黄色葡萄球菌，导致CD 4（+），CD 8（+）和总T淋巴细胞的长期下降，NK细胞的减少，持续大于或等于14天。相反，革兰氏阴性病原体（脑膜炎奈瑟菌，n = 8;肠杆菌，n = 2）导致的脓毒症患者在3天内实现了亚群的完全恢复。革兰氏阴性脓毒症患者外周血B淋巴细胞、CD 3（+）/DR+和CD 4（+）T淋巴细胞数量明显增加，且增加速度快于革兰氏阳性脓毒症患者。
Objective To determine the quantitative variances in peripheral blood lymphocyte subsets during sepsis, and their clinical significance.Methods Peripheral blood lymphocyte subsets were enumerated in 32 non-surgical septic patients during the first 14 days of hospitalization; results from septic patients were compared with those from 34 healthy controls. Influences of the severity and the bacterial etiology of sepsis on changes in lymphocyte subsets were also assessed.Results Significant decreases (P < 0.05) from normal values of CD4(+), CD8(+) and total T-lymphocytes were observed in septic patients, but the decline persisted only for CD4(+) T-lymphocytes and natural killer (NK) cells for 3 and 7 days, respectively. In addition, the numbers of CD3(+) DR+ lymphocytes were significantly elevated on day 14. There were no correlations between these alterations and the severity of sepsis. Gram-positive sepsis (n = 10), which was mainly due to Streptococcus pneumoniae and Staphylococcus aureus, caused prolonged decreases in CD4(+), CD8(+) and total T-lymphocytes, and a reduction in NK cells, that lasted for greater than or equal to14 days. Conversely, patients with sepsis due to Gram-negative pathogens (Neisseria meningitidis, n = 8; enterobacteria, n = 2) achieved full recovery of the subsets within 3 days. Moreover, the patients with Gram-negative sepsis demonstrated a significant increase in B-lymphocytes, and a rise in the numbers of CD3(+)/DR+ and CD4(+) T-lymphocytes, which were more rapid than in patients with Gram-positive sepsis.Conclusion Our results indicate that Gram-positive sepsis causes stronger suppression of peripheral blood lymphocyte subsets in comparison to sepsis due to Gram-negative pathogens.