LYMPHOCYTE SUBSET RESPONSES TO TRAUMA AND SEPSIS
LYMPHOCYTE SUBSET RESPONSES TO TRAUMA AND SEPSIS
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DOI：
10.1097/00005373-199312000-00007
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发表时间：
1993-12-01
影响因子：
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通讯作者：
POLK, HC
中科院分区：
文献类型：
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作者：
CHEADLE, WG;PEMBERTON, RM;POLK, HC
三个创伤中心收治的创伤严重度评分为20或更高的105例创伤患者在整个住院过程中具有淋巴细胞表型亚群特征。通过单克隆抗体和流式细胞术分析定量总淋巴细胞、泛T（CD 2）、辅助T（CD 4）、抑制T（CD 8）、泛B（CD 20）和DR表达淋巴细胞。分析了三个患者组的结果：未感染、顺利恢复（n = 64）;严重感染（n = 26）;和死亡（n = 15; 7例败血症）。与对照组相比，在伤后第一周出现明显的淋巴细胞减少，在第3天达到最大值（p < 0.05），并在研究期间恢复。在三个结果组之间发现了分层分布，其中死亡者中几种淋巴细胞表型的数量最少。辅助性T细胞和抑制性T细胞也受到类似的影响，但在注定要发生感染或死亡的患者中最低。然而，在所有三个结果组中，助抑比相似。因此，在损伤后早期进行旨在恢复这些亚群的调节可能会降低随后感染的风险。
One hundred five trauma patients admitted to three trauma centers with Injury Severity Scores of 20 or greater had lymphocyte phenotypic subsets characterized throughout their hospital course. Total lymphocytes, pan-T (CD2), helper T (CD4), suppressor T (CD8), pan B (CD20), and DR expressing lymphocytes were quantitated by monoclonal antibodies and flow cytometric analysis. Results were analyzed between three patient groups: uninfected, uneventful recovery (n = 64); major infection (n = 26); and dead (n = 15; 7 with sepsis). A significant lymphopenia, maximal at 3 days, occurred in the first postinjury week compared with controls (p < 0.05), which recovered over the study period. A hierarchical distribution was found between the three outcome groups with the lowest numbers of several lymphocyte phenotypes in those who died. T helper and suppressor cells were similarly affected, but lowest in patients destined to develop infection or die. The helper-suppressor ratio, however, was similar in all three outcome groups. Therefore, modulation early after injury aimed at restoring these subsets may reduce the risk of subsequent infection.