Analysis of monocyte function related to surgical stress and post operative infection

研究表明，单核细胞上的CD11b分子与迁移有关，单核细胞上的HLA-DR分子具有呈递抗原对抗T细胞的功能，从而激活细胞免疫。我们分析了手术应激引起的单核细胞表型变化和血浆细胞因子水平（IL-6、IL-8、ifn - γ）的改变。材料与方法行胃切除术（n=23， G组）、食管切除术（n=8， E组）、胰十二指肠切除术（n=7， P组）、急腹症急诊手术（n=4， Em组）。采用流式细胞术（FACScan）检测外周血单核细胞CD11b和HLA-DR的表达水平，ELISA检测术前、第1、第3、第5、第7、第7、第7个POD的血浆IL-6、IL-8、ifn - γ水平。各组术后均无重大并发症发生。结果各组间单核细胞计数差异无统计学意义。术前CD11b平均荧光强度（MFI）为37.7、29.6、32.1、12.3（G、E、P、Em组），第1个POD为29.8、18.6、29.4、19.1，第14个POD为33.0、18.3、22.5、39.7。术前HLA-DR MFI分别为62.7、61.9、48.7、113.5（G、E、P、Em组），第1次POD为46.9、65.0、38.8、27.0，第14次POD为48.0、83.9、27.5、98.2。血浆IL-6水平术前较其他组明显升高，术后恢复正常。术前和术后E组血浆IL-8水平均高于G组和P组。结论E组CD11b表达降低、IL-8等高细胞因子血症可能与SIRS发生机制有关。

It has been shown that CD11b molecules on monocytes is associated with migration and HLA-DR molecules on monocyte have function to present antigens against T cell, resulting in activation of cellular immunity. We have analyzed that phenotypic change of monocytes and alteration of plasma cytokine levels (IL-6, IL-8, IFN-gamma) due to surgical stress. Materials and method Gastrectomy (n=23, G group) , esophagectomy (n=8, E group) , pancreaticoduodenectomy (n=7, P group), Emergency operation against acute abdomen (n=4, Em group) were performed. The levels of CD11b and HLA-DR expression on peripheral monocytes were assayd by flow cytometric analysis (FACScan) and plasma IL-6, IL-8, IFN-gamma were measured by ELISA on preoperative period, 1st POD,3rd POD,5th POD,7th POD,and 7th POD,respectively. Every groups had no major postoperative complication. Results There is no significant difference of monocyte counts among groups. The mean fluorescence intensity (MFI) of CD11b expression were 37.7,29.6,32.1,12.3(G,E,P,Em group) on preoperative period, 29.8,18.6,29.4,19.1, on 1st POD and 33.0,18.3,22.5,39.7, on 14 POD,respectively. The MFI of HLA-DR were 62.7,61.9,48.7,113.5(G,E,P,Em group) on preoperative period, 46.9,65.0,38.8,27.0, on 1st POD and 48.0,83.9,27.5,98.2, on 14 POD,respectively. The plasma IL-6 levels were markedly increased preoperatively compared to the other groups and recovered to normal levels postoperatively. The plasma IL-8 levels of E groups were increased preoperatively and postoperatively compared to G or P group. Conclusion The decreased expression of CD11b and hypercytokinemia such as IL-8 in E group might be related to the mechanism of SIRS.