中国体外循环杂志2017，Vol.15Issue(2)：81-85,118,6.DOI:10.13498/j.cnki.chin.j.ecc.2017.02.05
调节性T细胞和辅助性T细胞与体外循环后肺损伤相关性的研究
The relation between Treg/Th17 and lung injury in patients undergoing cardiopul-monary bypass
摘要
Abstract
Objective To observe the change of the percentage of CD4+CD25+CD127low Treg and Th17 of CD4+T cells and the ratio of Treg/Th17 in patients who developed vary degree of lung injury after cardiopulmonary bypass during the perioperative period. Methods A total of 56 patients planned for the selected valves surgery were recruited in this study. Each patient's demographic as well perioperative laboratory and clinical data were collected. Patients'perioperative lab experiment results and variables including total by-pass time, incubated time, length of intensive care unit stay, and PaO2/FiO2 were also recorded. The blood samples were taken for the test of Treg and Th17 cells with flow cytometrybefore anesthetization( T1) , 30min after heparin neutralization ( T2) and at day 1( T3) and 3(T4) after surgery. The stored plasma was analyzed for IL-10 and IL-17Aby enzyme-linked immunosorbent assay (ELISA). The patients were divided into three groups( no, mild, moderate lung injury) according to the oxygenation index at 24 hours after ad-missionto ICU. Results Compared with the no or mild lung injury groups, the percentage of CD4+CD25+CD127low Treg and Th17 of CD4+T cells at T1 and T2 were lower( P=0.007, P=0.001) , the ratio of Treg/Th17 at T1 was lower( P=0.001) and the concentra-tion of IL-17A in the plasm was higher( P =0.001) in moderate lung injury group. The percentage of CD4+CD25+CD127low Treg of CD4+T cells at T1 and T2 was correlated with PaO2/FiO2( r=0.428, P<0.02;r=0.549, P<0.001) . The area under the curve( AUC) of the percentage of CD4+CD25+CD127lowTreg of CD4+T cells and the ratio of Treg/Th17 at T1 and T2 was 0.722 (95%CI 0.557-0.888), 0.787(95%CI 0.639-0.934), 0.751(95%CI 0.593-0.919), 0.551(95%CI 0.366-0.735, P=0.587) respectively. Conclu-sions Severe lung injury at 24 h after valves replacement is associated with lower levelsof CD4+CD25+CD127 low Treg of CD4+T cells, decreased ratio of Treg/Th17 at T1 and T2 and higher concentration of IL-17A after surgery. But there is no significant relation between the level of Th17 cells with the degree of lung injury. We speculate decrease of the percentage of Treg in CD4+T cellsand the ratio of Treg/Th17 may be the potential predictors for lung injury aftercardiopulmonary bypass.关键词
体外循环/炎症反应/肺损伤/Treg细胞/Th17细胞Key words
Cardiopulmonary bypass/Inflammatory response/Lung injury/Treg cell/Th17 cell引用本文复制引用
张晓阳,路丽明,李欣..调节性T细胞和辅助性T细胞与体外循环后肺损伤相关性的研究[J].中国体外循环杂志,2017,15(2):81-85,118,6.基金项目
上海市科委医学引导类项目( 09419966000) （ 09419966000）
