肺泡灌洗液Th17细胞水平对脓毒症急性肺损伤患儿预后的影响

Prognostic values of Th17 cells level in bronchoalveolar lavage fluid in children of sepsis with acute lung injury

摘要:

目的 研究脓毒症急性肺损伤患儿肺泡灌洗液Th17 细胞水平的变化及与预后的关系。方法 以50 例脓毒症急性肺损伤患儿为研究对象,采用流式细胞仪检测肺泡灌洗液Th17 细胞比例,同时在入院24 h内对患儿进行小儿危重病例评分(PCIS)。按PCIS 评分分为极危重组、危重组及非危重组;根据临床预后分为存活组及死亡组;分别比较Th17 细胞在各组的差异及其与PCIS 分数的相关性。结果 随着病情危重程度的增加,肺泡灌洗液中Th17 细胞水平逐渐增高,差异有统计学意义(P<0.05)。Th17 细胞水平与PCIS 评分呈负相关(r=-0.853,P<0.01)。死亡患儿Th17 细胞水平显著高于存活患儿,PCIS 评分低于存活患儿(P<0.05)。结论 脓毒症急性肺损伤患儿肺泡灌洗液中Th17细胞水平的增加与其病情严重程度及预后密切相关,提示其可作为病情严重程度及预后的预测指标。

Abstract:

Objective To observe the changes in Th17 cell levels in bronchoalveolar lavage fluid in children of sepsis with acute lung injury and the relationship between the Th17 cell levels and prognosis.Methods Fifty children of sepsis with acute lung injury were enrolled in the study. The percentages of Th17 cells in bronchoalveolar lavage fluid were measured by flow cytometry. The patients of sepsis with acute lung injury were classified into three groups based on the Pediatric Critical Illness Score (PCIS):extremely critical, critical and non-critical. According to the clinical prognosis, the patients were classified into survical and death groups. Th17 cell levels were compared between the two groups. The relationship between Th17 cell levels and the PCIS scores was analyzed.Results With the increase in the severity of sepsis, Th17 cell levels in bronchoalveolar lavage fluid were gradually increased (P<0.05). The Th17 cell levels were negatively correlated to the PCIS scores (r=-0.853; P<0.01). The Th17 cell levels were significantly higher in the death group than in the survival group. Moreover, compared with the survival group, the PCIS scores were lower in the death group (P<0.05).Conclusions The increased Th17 cell levels in children of sepsis with acute lung injury are closely related to the severity and prognosis of patients, suggesting that Th17 cell levels can be used as a predictor of the severity and prognosis.