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目的：探讨创伤患者单核细胞ＨＬＡ－ＤＲ抗原表达在创伤感染发生机制中的作用．方法：严重创伤患者２４例按临床结果分为创伤组（ｎ＝１７）和创伤感染组（ｎ＝７），于入院后第１、３、７天和１４天取血测定单核细胞ＨＬＡ－ＤＲ抗原表达率和血浆ＴＮＦ含量．结果：两组患者伤后第１天单核细胞ＨＬＡ－ＤＲ表达率分别为０．３２±０．０７和０．２６±０．１１，显著低于正常对照（０．６０±０．０６），伤后第３天创伤组已恢复至０．５０±０．０８，而创伤感染组仍较低下（０．３４±０．１４）．两组均见ＴＮＦ的短暂升高．结论：单核细胞ＨＬＡ－ＤＲ抗原表达在创伤后免疫功能紊乱及创伤感染的发生机制中起重要作用
Objective: To investigate the role of monocyte HLA-DR antigen expression in the pathogenesis of wound infection in traumatic patients. Methods: Twenty-four patients with severe trauma were divided into trauma group (n = 17) and traumatic infection group (n = 7) according to the clinical results. Blood samples were collected on the 1st, 3rd, 7th and 14th days after admission to determine the monocyte HLA- DR antigen expression and plasma TNF levels. Results: The HLA-DR expression rates of monocytes in the two groups after injury were 0.32 ± 0.07 and 0.26 ± 0.11, respectively, which were significantly lower than those of the normal control (0.60 ± 0.06) The trauma group recovered to 0.50 ± 0.08 on the third day after injury and remained low on the trauma infection group (0.34 ± 0.14). TNF was transiently elevated in both groups. CONCLUSION: Monocyte HLA-DR antigen expression plays an important role in the pathogenesis of posttraumatic immune dysfunction and wound infection