SEQUENTIAL, PROSPECTIVE ANALYSIS OF IMMUNOLOGICAL ABNORMALITIES AND INFECTION FOLLOWING SEVERE THERMAL INJURY
SEQUENTIAL, PROSPECTIVE ANALYSIS OF IMMUNOLOGICAL ABNORMALITIES AND INFECTION FOLLOWING SEVERE THERMAL INJURY
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DOI：
10.1097/00000658-197812000-00016
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发表时间：
1978-01-01
影响因子：
9
通讯作者：
MACMILLAN, BG
中科院分区：
文献类型：
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作者：
ALEXANDER, JW;OGLE, CK;MACMILLAN, BG
我们对20例烧伤患者的体液和细胞免疫功能进行了序贯、前瞻性分析。身体表面积的45%。感染患者对金黄色葡萄球菌502A的中性粒细胞杀灭活性明显低于未感染患者。中性粒细胞趋化性与感染相关性较差，但趋化性常异常。血清opsonic指数在烧伤后早期下降，但在烧伤后第4 ~ 14天恢复到接近正常值。感染和未感染患者之间没有差异。两组患者血清中Ig[免疫球蛋白]G、properdin和C3[补体成分3]的水平虽然较低，但在烧伤后第9天仍保持在正常范围内。许多患者在受伤后的前3周内，因子B水平迅速上升，达到正常水平的两倍以上。在19例菌血症发作中，有5例发生了对位蛋白的摄入。分离淋巴细胞对植物血凝素的反应正常。患者血清明显抑制正常淋巴细胞对PHA的反应性。个体患者的免疫特征分析表明，中性粒细胞功能异常是最重要的获得性缺陷，易导致患者在严重热损伤后发生菌血症；听觉作用异常起次要但重要的作用。
A sequential, prospective analysis of humoral and cellular immune function was performed on 20 burn patients with injuries involving .gtoreq. 45% total body surface area. Infected patients had significantly worse neutrophil bactericidal activity against Staphylococcus aureus 502A than did noninfected patients. Chemotaxis of neutrophils correlated poorly with infection although chemotaxis was frequently abnormal. The opsonic index of serum was depressed early after the burn but returned to nearly normal values by the 4th to the 14th post-burn day. There was no difference between infected and noninfected patients. Serum levels of Ig[immunoglobulin]G, properdin and C3 [complement component 3] while initially low, remained within the normal range after the 9th post-burn day in both groups. Factor B levels rose rapidly during the first 3 wk after injury to more than double normal levels in many patients. Suggestive evidence for consumption of opsonic protein occurred with 5 of 19 episodes of bacteremia. The responsiveness of isolated lymphocytes to PHA [phytohemagglutinin] was normal. Patients'' sera significantly inhibited the responsiveness of normal lymphocytes to PHA. Analysis of immunologic profiles for individual patients indicates that abnormalities of neutrophil function are the most important acquired defect predisposing patients to the development of bacteremia following major thermal injury; abnormalities of opsonic action play a secondary but important role.