Expression of mCD14 on peripheral blood mononuclear cell and cytokine in severe sepsis and its significance / 中国医师进修杂志

ABSTRACT

ObjectiveTo observe the expression of mCD14 and human leucocyte antigen (HLA)-DR on peripheral blood mononuclear cell( PBMC ) and cytokine in severe sepsis and its significance.MethodsThirty-five patients with severe sepsis (patients group) and 15 healthy volunteers (control group)were selected in this study.The expression of mCD14,HLA-DR on PBMC,serum tumor necrosis factor (TNF)- α,interleukin(IL)-10,the total score of acute physiology and chronic health evaluation(APACHE Ⅱ )and sepsis-related organ failure assessment (SOFA) score of the patients were measured at the 1st,3rd,5th day after admission.ResultsThe expression of mCD14 and HLA-DR on PBMC,the levels of serum TNF- α and IL-10 were ( 2.61 ± 1.59 )％,( 10.25 ± 5.35 )％,(96.66 ± 45.38) ng/L,( 149.74 ± 77.15 ) ng/L in patients group,(5.57 ± 1.53)％,(59.28 ± 14.76)％,(0.12 ±0.00) ng/L,(5.67 ±2.16) ng/L in control group,there were significant differences between two groups (P ＜ 0.05 or ＜ 0.01 ).In patients group,the mortality of 28 days was 28.6％(10/35).The expression of mCD14 and HLA-DR on PBMC,SOFA score and APACHE Ⅱ at the 1st,3rd day showed no statistical significance between non-survivor patients and survivor patients (P ＞ 0.05 ),but at 5th day the expressions of mCD14 and HLA-DR on PBMC in survivor patients were significantly higher than those in non-survivor patients [ (5.12 ± 2.03 )％ vs.(2.75 ± 0.67 )％; (35.12 ±9.29)％ vs.(13.06 ±5.87) ％](P＜0.01 or ＜ 0.05),SOFA score and APACHE Ⅱ were significantly lower than those in non-survivor patients[ (4.48 ± 1.71 ) scores vs.( 10.70 ± 3.16 ) scores; (9.36 ± 5.57 ) scores vs.(25.60 ± 10.88) scores](P＜ 0.01 ).The levels of serum TNF- α and IL-10 at the 1st,3rd,5th day showed no statistical significance between non-survivor patients and survivor patients(P ＞ 0.05).Conclusions The expressions of mCD14 and HLA-DR on PBMC in severe sepsis show closely related to the outcome.The changes of serum TNF- α and IL- 10 can not reflect the prognosis of severe sepsis in 5 days.