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目的探讨白细胞粘附分子在急性肺损伤(ALI)/急性呼吸窘迫综合征(ARDS)发病机制中的作用。方法采用流式细胞术,用单克隆抗体定量测定2004年6月至2005年12月华中科技大学同济医学院附属同济医院重症监护病房的26例ALI患者、18例ARDS患者和15名健康人外周血中白细胞粘附分子CD11a、CD11b和CD18的阳性表达率,并比较治愈组与死亡组患者白细胞粘附分子CD11a、CD11b和CD18的阳性表达率。结果ALI组和ARDS组外周血中性粒细胞和单核细胞表面的CD11a、CD11b和CD18明显高于健康对照组(P<0.01),ARDS组中性粒细胞、单核细胞和淋巴细胞表面的CD11a、CD11b和CD18,明显高于ALI组(P<0.05);死亡组患者中性粒细胞表面的CD11a、CD11b和CD18明显高于治愈组(P<0.05)。结论ALI患者通过中性粒细胞和单核细胞CD11a/CD18、CD11b/CD18的表达上调,ARDS患者通过中性粒细胞、单核细胞和淋巴细胞表面CD11a/CD18、CD11b/CD18的表达上调,参与各自疾病的病理发展过程。中性粒细胞CD11a/CD18、CD11b/CD18的表达水平与预后密切相关。
Objective To investigate the role of leukocyte adhesion molecules in the pathogenesis of acute lung injury (ALI) / acute respiratory distress syndrome (ARDS). Methods Flow Cytometry was used to measure the peripheral blood levels of 26 ALI patients, 18 ARDS patients and 15 healthy persons in Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from June 2004 to December 2005 with monoclonal antibody. The positive rates of leukocyte adhesion molecules CD11a, CD11b and CD18 in blood were calculated. The positive rates of leukocyte adhesion molecules CD11a, CD11b and CD18 in the patients of the two groups were compared. Results The levels of CD11a, CD11b and CD18 on the peripheral blood neutrophils and monocytes in ALI group and ARDS group were significantly higher than those in healthy control group (P <0.01). The levels of neutrophil, monocyte and lymphocyte surface CD11a, CD11b and CD18 in the dead group were significantly higher than those in the ALI group (P <0.05). CD11a, CD11b and CD18 on the neutrophils in the death group were significantly higher than those in the cured group (P <0.05). Conclusions The expression of CD11a / CD18 and CD11b / CD18 in neutrophils and monocytes is upregulated in patients with ALI. The expression of CD11a / CD18 and CD11b / CD18 on the surface of neutrophils, monocytes and lymphocytes in ARDS patients is increased Pathological development of their respective diseases. Neutrophil CD11a / CD18, CD11b / CD18 expression level and prognosis are closely related.