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Changes in human leukocyte antigen-DR expression on monocytes and its value of prediction on infection complication in trauma patients
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- Author:
- No author available
- Journal Title:
- CHINESE CRITICAL CARE MEDICINE
- Issue:
- 4
- DOI:
- 10.3760/j.issn:1003-0603.2004.04.001
- Key Word:
- 创伤;HLA-DR;感染并发症
Abstract： 目的探讨创伤患者单核细胞人类白细胞抗原DR(HLA-DR)抗原分子的表达变化规律,及其对伤后感染并发症的预测价值.方法应用流式细胞仪连续监测54例创伤患者伤后单核细胞HLA-DR抗原分子的表达,并根据创伤严重程度分组进行分析.另对34例严重创伤患者,根据其感染发生与否及严重程度分组进行分析.结果创伤患者伤后单核细胞表达HLA-DR的阳性细胞率和平均荧光强度均出现降低,以伤后2 d达到低谷,之后逐渐恢复;与健康对照相比,中度和重度创伤患者单核细胞HLA-DR抗原分子出现明显的低表达;轻度创伤患者与健康对照相比,重度与中度创伤患者相比, HLA-DR的表达变化均无明显的差异.另外,严重创伤患者单核细胞HLA-DR的表达变化与感染并发症发生与否及严重程度有明显的相关性;非感染患者伤后2 d单核细胞HLA-DR的表达降到最低,随后逐渐恢复正常;局部感染患者伤后前4 d单核细胞HLA-DR的表达明显低于非感染患者,6 d后逐渐恢复正常;并发全身感染患者,伤后单核细胞HLA-DR的表达阳性细胞率于伤后1～14 d,平均荧光强度于伤后2～14 d均明显低于局部感染患者.死亡的2例患者,单核细胞HLA-DR的表达持续低下直至死亡.结论严重创伤患者单核细胞HLA-DR分子表达量明显降低,且HLA-DR的表达变化与患者感染并发症的发生、发展及预后有明显的关系.
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