摘要
目的探讨外科治疗中严重腹腔感染脓毒症患儿Th1/Th2细胞免疫应答的变化规律。方法选择本院收治的30例严重腹腔感染患儿为脓毒症组。同期门诊查体的30例健康儿童为健康对照组。脓毒症组(于术前和术后第1、5天)及健康对照组抽取空腹静脉血2 mL,采用双抗体夹心酶联免疫吸附法(ELISA)测定各组儿童血清IFN-γ和IL-4水平,计算IFN-γ/IL-4比值。采用SPSS10.0软件进行统计学分析。结果脓毒症组血清IFN-γ水平术前与健康对照组、术后第5天与术前、术后第5天与健康对照组比较,均无显著性差异(Pa>0.05);术后第1天与术前比较下降(t=6.083 P<0.01)。脓毒症组血清IL-4水平术前与健康对照组、术后第1天比较均升高(t=11.65,1.996 Pa<0.01),与术后第5天比较下降(t=8.275 P<0.01),术后第5天与健康对照组比较仍高,未恢复至正常水平(t=3.453 P<0.01)。脓毒症组IFN-γ/IL-4比值术前与健康对照组、术后第1天比较均明显降低(t=10.98,3.072 Pa<0.05),术后第5天与术前比较明显升高(t=6.417 P<0.01),但与健康对照组比较未恢复至正常水平(t=3.482 P<0.01)。结论严重腹腔感染脓毒症患儿Th1细胞应答减弱,Th2细胞应答增强,存在免疫抑制状态,手术打击加重Th1细胞向Th2细胞偏移,经手术干预、合理治疗,免疫功能可逐渐恢复。
Objective To investigate the immunoresponsiveness of Th1/Th2 cells in children with surgical sepsis. Methods Sepsis group ：30 children with severe intra -abdominal infection were hospitalized in Departmant of Pediatric Surgery. Thirty healthy children during healthy examination period were selected as healthy control group（ group C ）. Fasting venous blood obtained from 60 children. ELISA was used to detect the levels of interferon-γ （IFN -γ） and interleukin-4 （IL-4） in the serum of group C and sepsis group [ on days preoperation （SO ） and the 1^st ,5^th postoperation（ S1,S5 ） ]. SPSS 10.0 software was used to analyze the data. Results IFN -γ/：there was no difference in group So and group C （ P 〉 0.05 ） ; IFN - γ, in group S1 was significant lower than that in group SO （ t = 6. 083 P 〈 0.01 ） ; There was no difference in group S5 and group So （ P 〉 0. 05 ） ; There was no difference in group S5 and group C （ P 〉 0. 05 ）. IL - 4 in group S0 was significant higher than that in group C （ t = 11.65 P 〈 0. 01 ） ; IL - 4 in group S1 was significant higher than that in group So （ t = 1. 996 P 〈 0. 01 ） ; IL - 4 in group S5 was significant lower than that in group SO （ t = 8. 275 P 〈 0.01 ） ; IL - 4 in group S5 was significant higher than that in group C （ t = 3. 453 P 〈 0.01 ）. IFN - 3,/IL - 4 ratio in group SO was significant lower than that in group C （ t = 10.98 P 〈 0. 01 ） ; IFN - γ/ IL - 4 ratio in group S1 was significant lower than that in group SO （ t = 3. 072 P 〈 0.05 ） ; IFN - γ/IL - 4 ratio in group S5 was significant higher than that in group So （ t = 6.417 P 〈 0.01 ） ; IFN - γ/IL - 4 ratio in group S5 was significant lower than that in group C （ t = 3. 482 P 〈 0.01 ）. Conclusions There is a decrease in Thl response and an increase of Th2 response that may lead to immune suppression in children with surgical sepsis. The surgery can make immune suppression more serious and the immune suppression can reach to normal by activing treatment during the days of postoperation.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2009年第11期832-833,868,共3页
Journal of Applied Clinical Pediatrics
