| 钟 坚,张 伟,陈 丹,李少洪,陈 晶.脓毒症患者外周血T淋巴细胞PD-1表达变化及胸腺肽α-1的免疫调理作用研究[J].,2021,(13):2447-2450 |
| 脓毒症患者外周血T淋巴细胞PD-1表达变化及胸腺肽α-1的免疫调理作用研究 |
| Expression of PD-1 on Peripheral Blood T Lymphocytes and Immunomodulatory Effect of Thymosin α-1 in Patients with Sepsis |
| 投稿时间：2021-02-21 修订日期：2021-03-18 |
| DOI：10.13241/j.cnki.pmb.2021.13.010 |
| 中文关键词: 脓毒症 T淋巴细胞 程序性细胞死亡受体1 胸腺肽α-1 免疫功能 |
| 英文关键词: Sepsis T lymphocyte Programmed cell death receptor 1 Thymosin α-1 Immune function |
| 基金项目:国家自然科学基金项目（81673835）；东莞市社会科技发展重点项目（2018507150461630） |
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| 中文摘要: |
| 摘要 目的：探讨脓毒症患者外周血T淋巴细胞程序性细胞死亡受体1（PD-1）表达特点，分析胸腺肽?琢-1治疗对患者免疫功能的影响。方法：选择2018年3月至2020年6月我院重症医学科收治的140例脓毒症患者（脓毒症组）和同期于我院进行体检的95例健康志愿者（对照组），根据急性生理与慢性健康评估Ⅱ（APACHE Ⅱ）、序贯器官衰竭评估（SOFA）评分结果将脓毒症患者分为APACHE Ⅱ 0~10分组（51例）、11~20分组（62例）和＞20分组（27例）；SOFA评分0~5分组（48例）、6~10分组（60例）和＞10分组（32例）。检测外周血CD4+T细胞上PD-1表达、CD8+T细胞上PD-1表达，比较组间差异性。Pearson秩相关性分析外周血CD4+T细胞上PD-1表达、CD8+T细胞上PD-1表达与APACHE Ⅱ、SOFA评分相关性。根据治疗方法将脓毒症患者分为A组（60例）和B组（80例），A组给予常规综合治疗和乌司他丁治疗，B组在A组的基础上联合胸腺肽α-1治疗，比较两组治疗前后外周血T淋巴细胞（CD3+、CD4+、CD8+）、NK细胞（CD3-CD16+CD56+）差异。结果：脓毒症组外周血CD4+T细胞上PD-1表达、CD8+T细胞上PD-1表达高于对照组（P＜0.001），外周血CD4+T细胞上PD-1表达、CD8+T细胞上PD-1表达随APACHE Ⅱ、SOFA评分的增加而增高，各组间差异显著（P＜0.05）。Pearson秩相关分析结果显示外周血CD4+T细胞上PD-1表达、CD8+T细胞上PD-1表达与APACHE Ⅱ评分、SOFA评分呈正相关（r=0.569、0.475；0.653、0.509，P均＜0.05）。B组治疗后CD3+、CD4+、CD3-CD16+CD56+高于A组（P＜0.05），CD8+低于A组（P＜0.05）。结论：脓毒症患者外周血CD4+、CD8+T细胞上PD-1表达均增高，其表达与病情严重程度密切相关。给予胸腺肽α-1治疗可改善患者免疫功能。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the expression of programmed cell death receptor-1 (PD-1) on peripheral blood T lymphocytes in patients with sepsis, and to analyze the effect of thymosin α-1 on immune function. Methods: 140 patients with sepsis (sepsis group) and 95 healthy volunteers (control group) received physical examination in our hospital at the same time were selected from March 2018 to June 2020. According to the results of acute physiology and chronic health assessment II (APACHE II) and sequential organ failure assessment (SOFA), the patients with sepsis were divided into Apache Ⅱ 0~10 scores group (51 cases), 11~20 scores group (62 cases) and > 20 scores group (27 cases), SOFA 0~5 scores group (48 cases), 6~10 scores group (60 cases), > 10 scores group(32 cases). PD-1 expression on CD4+T cells and PD-1 expression on CD8+T cells were detected. Pearson rank correlation analysis was used to analyze the correlation between the expression of PD-1 on CD4+T cells and the expression of PD-1 on CD8+T cells and Apache Ⅱ and SOFA scores. According to the treatment methods, sepsis patients were divided into group A(60 cases) and group B(80 cases). Group A was given conventional comprehensive treatment and ulinastatin treatment, while group B was given thymosin α-1 treatment on the basis of group A, The differences of peripheral blood T lymphocytes(CD3+, CD4+, CD8+) and NK cells(CD3-CD16+CD56+) between the two groups before and after treatment were compared. Results: PD-1 expression on CD4+T cells and PD-1 expression on CD8+T cells in sepsis group were higher than those in control group (P<0.001). PD-1 expression on CD4+T cells and PD-1 expression on CD8+T cells in peripheral blood increased with the increase of APACHE II and SOFA scores(P<0.05). Pearson rank correlation analysis showed that the expression of PD-1 on CD4+T cells and CD8+T cells were positively correlated with APACHE II and SOFA score (r=0.569, 0.475, 0.653, 0.509, all P<0.05). After treatment, CD3+, CD4+, CD3-CD16+CD56+ in group B were higher than those in group A(P<0.05), and CD8+ in group B was lower than that in group A (P<0.05). Conclusion: The expression of PD-1 on CD4+ and CD8+T cells in patients with sepsis is increased, which is closely related to the severity of sepsis. Thymosin α - 1 treatment can improve the immune function of patients. |
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