标题：重度烧伤创面免疫细胞变化与临床意义

      作者：李鸿明 1，周金武 1，毛高才 2，陈建设 1，沈光裕 1
    (中国人民解放军第187医院烧伤整形科 1、病理科 2，海南 海口 570206)

      卷次： 2016年27卷16期

      【摘要】 目的 观察烧伤患者的白细胞亚群随时间的变化，并探讨其与烧伤严重程度的关系。方法 选取我
院2013年11月至2014年12月收治的22例中重度烧伤患者，分别于烧伤后3 d、1周、2周、3周从深Ⅱ度烧伤的创面
提取标本。采用组织化学和免疫组织化学法，使用白细胞抗体，检测中重度烧伤患者移行区(坏死与存活组织交界
区域)伤后不同时间点白细胞亚群的变化。结果 中度烧伤组在伤后3 d移行区可见到白细胞浸润，2~3周后见到
大量白细胞浸润，早期多形核白细胞(PMN)多见，晚期单核细胞(MNC)多见；重度烧伤组早期移行区鲜有白细胞，晚
期可见少量PMN。伤后2周中度烧伤组移行区T细胞、Th细胞、Tc细胞均多于重度烧伤组，差异有统计学意义(P<
0.05)，B细胞数量两组相似，差异无统计学意义(P>0.05)，中度烧伤组鲜见 IL-2Rα+细胞，重度烧伤组未见到 IL-2Rα+
细胞。结论 烧伤后白细胞浸润、烧伤严重程度和时间密切相关，反映了受伤区域抗感染能力和免疫排斥能力的
改变，为合理治疗和延长移植皮肤的寿命提供了理论依据。

      【关键词】 白细胞；烧伤；感染；免疫组化

      【中图分类号】 R644 【文献标识码】 A 【文章编号】 1003—6350（2016）16—2624—03


Immunocytes changes after severe burn wound and the clinical significance.
LI Hong-ming 1, ZHOU Jin-wu 1, MAO
Gao-cai 2, CHEN Jian-she 1, SHEN Guang-yu 1. Department of Buns and Plastic Surgery 1, Department of Pathology 2, the
187th Hospital of Chinese PLA, Haikou 571159, Hainan, CHINA

【Abstract】 Objective To observe the effects of leukocyte subsets variation in burn patients, and to investigate
the relationship with the severity of burns. Methods The specimens were extracted from 22 moderate and severe burn
patients hospitalized from Nov. 2013 to Dec. 2014, in 3 days, 1 week, 2 weeks, 3 weeks respectively. By using histo-
chemical and immunohistochemical method, change of leukocyte subsets from transition zone of moderate and severe
burns was tested at different times with white cell antibodies. Results Infiltration of leukocytes can be observed 3 days
after burn in burn area of moderate burns, and they grew in number in 2~3 weeks. The leukocytes are polymorphonucle-
ar in early stage and mononuclear in later period. The leukocytes were rare in early stage after burn in burn area of se-
vere burns and few polymorphonuclear cells can be found in later period. The number of T cell, Th cell, Tc cell of moder-
ate burns was significantly more than that of severe burns (P<0.05). The number of B cell was similar in burn area of
moderate and severe burns (P>0.05). Few IL-2Rα+ cells can be found in burn area of moderate burns and there is no
IL-2Rα+ cells in severe burns. Conclusion The infiltration of lymphocytes after burns is closely related to burn severi-
ty and time. These reflect the ability of anti-infection and immune response in injured area. Our results provide a theoreti-
cal basis for the reasonable treatment and prolong the life of skin transplantation.

      【Key words】 Leukocyte; Burn; Infection; Immunohistochemical method
·论 著·
6350.2016.16.015