Study On The Dynamic Changes Of Cellular Immunity And Its Related Factors In Patients With Multiple Trauma

Objective: To investigate the dynamic change of cellular immune function in the early stage of severe trauma and to monitor the changes of CD4 + CD25 + CD127-regulatory T cells(Treg)and the levels of inflammatory factors in peripheral blood of patients with multiple trauma.To provide theoretical guidance for clinical treatment of polytrauma.Methods: Twenty-nine cases with multiple trauma were selected as the experimental group(ISS> 16 points),and 30 healthy subjects were taken as the control group.The peripheral venous blood(8ml)were taken on 1st,4th and 7th day after trauma,while the control was taken only once.The percentages of CD4 +,CD8 + and CD4 + CD25 + CD127-regulatory T cells(Treg)of each blood sample were measured by flow cytometry machine;and C-reactive protein(CRP)and interleukin-6(IL-6)were measured by immunoturbidimetry and chemiluminescence methods,respectively.T test was used for comparison between groups,and correlation analysis was performed by Pearson linear correlation analysis.Results: The percentages of CD4 + cells in peripheral blood of patients with severe multiple trauma from 1 to 7 day after trauma were significantly lower than those in healthy controls(P <0.01);and The percentages of CD8 + cells were significantly higher than those of healthy controls from 1to 7 day after injury,but the differences between the two groups in first days was not statistically significant(P > 0.05),which was statistically significant on 4th and 7th day(P < 0.01 or P < 0.05).The ratio of CD4 + / CD8 + was significantly lower lower than that of healthy control group from 1to 7 days after injury(P <0.01),and the differences were statistically significant(P> 0.01)on 1st and 4th day(P <0.05),but no significant difference on 7th day(P = 0.16> 0.05).CD4+CD25+CD127-regulatory(Treg)T cells on 1st,4th,and 7th days were significantly higher than those in the control group(P < 0.05).In addition,the levels of CRP and IL-6 in peripheral blood of patients with multiple trauma were significantly higher than those in control group(P <0.01)from 1 to 7 days after injury.Eventually,the CD4 + CD25 + CD127-regulatory T cells(Treg)were positively correlated with CRP and IL-6,but negatively correlated with CD4 +,CD8 + on the first day after injury.Conclusion: There are downing cellular immune function and excessive inflammatory reaction in the early stage of severe trauma in patients with multiple trauma.In addition,the rate of Treg cells after severe trauma was significantly higher,which may be associated with the inhibition of cellular immune function.In addition to CD4+,CD8+,CD4+/CD8+ ratio,Treg cell ratio can also be used as an early evaluation index of cellular immune function in patients with multiple injuries.Meanwhile,monitoring these indexes has positive significance in judging the timing of operation.