T淋巴细胞亚群与四肢骨折感染的相关性研究

发布时间：2018-08-26 09:25

【摘要】：目的探讨外周血T淋巴细胞亚群与四肢开放性骨折感染的关系。方法选取2014年1月1日至2015年1月1日于该院骨科进行手术治疗的223例四肢开放性骨折患者,根据是否感染分为感染组(34例)与未感染组(189例)。另选取同期体检健康者30例作为健康对照组。患者于入院时、术后1d,健康对照组于体检过程中采静脉血,以流式细胞法检测外周血T淋巴细胞亚群及辅助性T淋巴细胞(Th)1/Th2比值并进行比较,同时采用多因素Logistic回归分析T淋巴细胞亚群及Th1/Th2平衡与四肢开放性骨折感染的关系。结果感染组与未感染组患者入院时CD4~+细胞百分比、CD4~+/CD8~+比值、Th1细胞百分比、Th1/Th2比值均明显低于健康对照组,CD8~+细胞百分比和Th2细胞百分比明显高于健康对照组,差异均有统计学意义(P0.05);并且感染组患者入院时及术后1dCD4~+细胞百分比和CD4~+/CD8~+比值、Th1细胞百分比、Th1/Th2比值均明显低于未感染组,而CD8~+细胞百分比和Th2细胞百分比明显高于未感染组,差异均有统计学意义(P0.05);多因素Logistic回归分析显示,四肢骨折感染与术后1dCD4~+细胞百分比、CD4~+/CD8~+比值、Th1细胞百分比及和Th1/Th2比值明显相关(P0.05)。结论入院初期及术后四肢开放性骨折患者外周血CD4~+/CD8~+及Th1/Th2细胞平衡紊乱是发生感染的危险因素之一,应引起临床重视。
[Abstract]:Objective to investigate the relationship between T lymphocyte subsets in peripheral blood and infection of open fracture of extremities. Methods 223 patients with open fracture of extremities were selected from January 1, 2014 to January 1, 2015. According to whether they were infected or not, the patients were divided into infected group (34 cases) and non-infected group (189 cases). Another 30 healthy persons were selected as healthy control group. On admission and 1 day after operation, venous blood was collected in the healthy control group. The peripheral blood T lymphocyte subsets and the ratio of (Th) 1/Th2 of auxiliary T lymphocytes were detected by flow cytometry and compared. At the same time, multivariate Logistic regression analysis was used to analyze the relationship between T lymphocyte subsets, Th1/Th2 balance and open fracture infection in extremities. Results the percentage of CD4~ cells and the percentage of Th1 / Th1 / Th1 / Th1 / Th1 / Th1 / Th1 / Th1 / Th1 / Th2 ratio were significantly lower in infected and uninfected patients than in healthy controls. The percentage of CD4 ~ cells and the percentage of Th1 / Th _ 1 cells in CD4~ / CD8 ~ ratio were significantly lower in the infected group than in the uninfected group, while the percentage of CD8~ cells and the percentage of Th2 cells in the infected group were significantly higher than those in the uninfected group. Multivariate Logistic regression analysis showed that the percentage of CD4 ~ cells and the ratio of CD4 ~ / CD8 ~ were significantly related to the percentage of Th1 cells and the ratio of Th1/Th2 (P0.05). Conclusion the disturbance of CD4~ / CD8 ~ and Th1/Th2 cell balance in peripheral blood of patients with open fracture of extremities at the beginning of admission and after operation is one of the risk factors of infection, which should be paid more attention to in clinic.
【作者单位】：柳州市工人医院创伤中心;
【基金】：广西壮族自治区卫生厅自筹经费科研基金资助项目(Z2013625)
【分类号】：R683

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