关键词:

胸部创伤, 调节性 T 淋巴细胞, Th1/Th2 细胞因子, 创伤后感染, γ 干扰素, 白细 胞介素?4

Abstract:

Objective To investigate the relationship between early changes of serum regulatory T lympho⁃ cytes and helper T cell 1/helper T cell 2（Th1/Th2）cytokines and post ⁃traumatic infection in patients with chest trauma. Methods A total of 160 patients with chest trauma were selected and divided into infected group and non⁃ infected group. The basic information of the patient was recorded in detail. White blood cell（WBC），procalcitonin （PCT），CD4+ /CD25+ T lymphocyte count，Th1 related cytokine γ interferon（IFN⁃γ）and Th2 related cytokine inter⁃ leukin⁃4（IL⁃4）levels within 24 h after admission were also recorded. The factors of infection after thoracic trauma were analyzed. Results （1）Among 160 patients with chest trauma，46 cases（28.75%）were complicated with infection，while 114 cases（71.25%）were not.（2）There were significant differences in age，mechanical ventila⁃ tion time，combined brain injury，ISS score and APACHE⁃II score between the infected group and the non⁃infected group（P < 0.05）.（3）The level of PCT，WBC，and IFN⁃γ/IL⁃4 in the infected group was higher than that in the non⁃infected group（P < 0.05）. The level of CD4+ /CD25+ in the infected group was lower than that in the non⁃infect⁃ ed group（P < 0.05）.（4）Multi⁃factor logistic regression analysis showed that the duration of mechanical ventila⁃ tion，combined with brain injury，ISS score，APACHE⁃II score，PCT，IFN⁃γ/IL⁃4，and CD4+ /CD25+ were the sig⁃ nificant or correlated factors of the infection in patients with chest trauma（P < 0.05）. Conclusion In the early stage of post ⁃traumatic infection，patients have immunologic dysfunction. Advanced age，brain injury，high ISS score，high APACHE⁃II score，increased IFN⁃γ/IL⁃4 and decreased CD4+ /CD25+，may increase the risk of post⁃ traumatic infection.

Key words:

chest trauma, regulatory t lymphocytes, Th1/Th2 cytokines, posttraumatic infection, gamma interferon, interleukin?4