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目的:探讨急性胰腺炎(AP)患者中性粒细胞(PMNs)表面CD11b和CD18抗原的表达及其吞噬功能及其与AP感染并发症的关系。方法:选取2年间收治的发病24 h内入院的AP患者,分为轻型组(MAP)和重型组(SAP)分别观察,另设对照组对比。入院第1,3,7天抽取外周静脉血,测定PMNs表面CD11b和CD18的表达以及其吞噬功能。结果:AP患者在发病后第1天PMNs表面CD11b和CD18表达增强,MAP组和SAP与对照组比较,均有统计学意义(P<0.05);MAP组和SAP组DHR荧光强度均减弱,与对照组比较均有统计学意义(P<0.05)。第3天时MAP组PMNs表面CD11b表达恢复正常,DHR增强;而在SAP组PMNs表面CD11b表达持续增强,至第7天CD11b表达恢复正常,DHR荧光强度却进一步减弱,以上指标与对照组比较均有统计学意义(P<0.05)。结论:SAP时PMNs表面CD11b和CD18表达持续增强,但DHR表达反而下降,表明PMNs吞噬功能降低,这可能是SAP易发感染的重要因素之一。
Objective: To investigate the expression of CD11b and CD18 antigens and their phagocytosis on the surface of neutrophils (PMNs) in patients with acute pancreatitis (AP) and their relationship with AP complications. Methods: AP patients admitted within 24 hours of onset within 2 years were divided into light group (MAP) and heavy group (SAP), respectively. Peripheral venous blood was drawn on the 1st, 3rd, 7th day after admission to determine the expression of CD11b and CD18 on the surface of PMNs and their phagocytic function. Results: The expression of CD11b and CD18 on the surface of PMNs in AP patients was increased on the 1st day after the onset of disease. The MAP fluorescence intensity and SAP in the MAP group and the SAP group were significantly lower than those in the control group (P <0.05) The control group were statistically significant (P <0.05). On the third day, the expression of CD11b on the surface of PMNs in MAP group returned to normal and the DHR increased. On the other hand, the expression of CD11b on the surface of PMNs in SAP group continued to increase. The expression of CD11b returned to normal on the 7th day and the fluorescence intensity of DHR was further weakened. Statistical significance (P <0.05). CONCLUSIONS: The expression of CD11b and CD18 on PMNs continues to increase but the expression of DHR decreases on the surface of SAP, which indicates that the phagocytic function of PMNs is decreased. This may be one of the important factors of SAP susceptibility to infection.