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目的了解严重烧伤患者外周血树突状细胞(DC)功能变化。方法对12例烧伤面积60%～99%的烧伤患者,分别于伤后第1、2、3、4周取外周静脉血分离培养 DC,单克隆抗体标记后,采用流式细胞仪测定 DC 表型组织相容性抗原(HLA)-DR、CD80、CD83、CD86、CD14、CD11C 的表达水平。10例健康志愿者外周血 DC 作为对照组。结果在伤后1、2、3、4周烧伤患者外周血 DC 表面标记表达的 HLA-DR 分别为62.1%±8.4%、65.0%±6.2%、68.4%±5.7%、75.4%±8.4%,对照组为93.9%±2.2%(均 P<0.05);CD80为12.9%±3.7%、14.7%±2.5%、16.1%±4.2%、16.2%±4.8%,对照组24.3%±11.6%(均 P<0.001);CD83为15.1%±4.2%、15.1%±4.0%、22.2%±7.7%、21.3%±7.0%,对照组28.1%±5.1%(均 P<0.001);CD86为69.2%±7.1%、70.5%±5.4%、75.1%±6.1%、79.6%±6.4%,对照组84.3%±8.2%(P<0.001),它们较对照组阳性表达率明显下降。CD14的阳性表达率为12.7%±1.9%,12.0%±1.5%,11.3%±1.3%,9.3%±1.7%,较对照组(7.3%±1.5%)则显著升高(P<0.001);CD11c 的阳性表达率为86.8%±6.1%、89.5%±5.1%、91.3%±2.8%、89.4%±4.0%,较对照组(92.6%±3.8%)虽有降低,但差异无统计学意义(均 P>0.05)。HLA-DR 阳性表达率从伤后第4周始有升高趋势,但仍明显低于正常对照组(P<0.05)。结论严重烧伤患者伤后外周血树突状细胞功能下降,是机体免疫系统功能抑制的重要部分,也是烧伤后引起全身感染的一个重要原因。
Objective To investigate the changes of peripheral blood dendritic cells (DCs) in patients with severe burns. Methods 12 cases of burn patients with burn area of 60% -99% were divided into peripheral venous blood at week 1, 2, 3, and 4 after injury for DC separation. After labeling with monoclonal antibody, DCs were measured by flow cytometry HLA-DR, CD80, CD83, CD86, CD14, CD11C expression levels. Peripheral blood DC from 10 healthy volunteers served as control group. Results The HLA-DR of peripheral blood mononuclear cells in burn patients were 62.1% ± 8.4%, 65.0% ± 6.2%, 68.4% ± 5.7%, 75.4% ± 8.4% respectively, The control group was 93.9% ± 2.2% (all P <0.05). The CD80 was 12.9% ± 3.7%, 14.7% ± 2.5%, 16.1% ± 4.2%, 16.2% ± 4.8% and 24.3% ± 11.6% P <0.001). CD83 was 15.1% ± 4.2%, 15.1% ± 4.0%, 22.2% ± 7.7%, 21.3% ± 7.0% and control group was 28.1% ± 5.1% 7.1%, 70.5% ± 5.4%, 75.1% ± 6.1%, 79.6% ± 6.4%, and 84.3% ± 8.2% (P <0.001) in the control group, which were significantly lower than those in the control group. The positive rate of CD14 expression was 12.7% ± 1.9%, 12.0% ± 1.5%, 11.3% ± 1.3% and 9.3% ± 1.7%, respectively, which was significantly higher than that of the control group (7.3% ± 1.5% The positive rate of CD11c was 86.8% ± 6.1%, 89.5% ± 5.1%, 91.3% ± 2.8%, 89.4% ± 4.0%, which was lower than that of the control group (92.6% ± 3.8%), but the difference was not statistically significant (All P> 0.05). The positive rate of HLA-DR increased from the 4th week after injury, but still significantly lower than that of the normal control group (P <0.05). Conclusion The function of dendritic cells in the peripheral blood of severely burned patients is decreased, which is an important part of the immune system’s function suppression and an important cause of systemic infection after burn.