瘢痕患者免疫功能状态研究瘢痕患者免疫功能状态研究［摘耍］目的：通过比较不同程度瘢痕患者和健康对照组的细胞免疫和体液免疫的差异，分析瘢痕患者免疫功能状态，探讨瘢痕可能的免疫学发生机制。方法:101例瘢痕患者分为三组：轻度瘢痕组、中度瘢痕组和重度瘢痕组。选择健康体检者50例做为正常对照组。测定T细胞亚群比例和CD8T淋巴细胞的杀伤活性，同时，检测CD8T淋巴细胞培养上清液中TNF-B水平。分別采用生物学活性法和ELISA测定瘢痕患者和正常对照IFN-Y和IL-4分泌水平。结果：不同组别CD8T细胞亚群比例比较结果和CD4T细胞相似，即在对照组和轻度瘢痕组，中度瘢痕组和重度瘢痕组差异不具有显著性，其余各组间差异具有显著性。血清中IFN-y在各组间差异均具有显著性；上述各组血清中IL-4表达水平除在轻度和中度瘢痕组间差异不具有显著性外,其它各组间差异均具有统计学意义。CD8T淋巴细胞杀伤效应在效靶比为5:1时，除轻度瘢痕和中度瘢痕组间差异不具有显著性外，其余各组间差异均具有统计学意义。CD8T细胞培养上清中TNF-I3水平在各组间差异均具有显著性。结论：同对照组比较，瘢痕患者适应性免疫出现以细胞免疫功能升高，伴随体液免疫功能降低的趋势，并且随着瘢痕程度的加重，这种变化渐趋明显。提示，瘢痕组织的形成可能与机体细胞免疫功能异常升高和体液免疫功能水平降低有关。［关键词］瘢痕；Thl型细胞因子；Th2型细胞因子；CD8T细胞［中图分类号］R619+.6R320.2［文献标识码］A［文章编号］1008-6455(2011)02-0247-05StudyontheadoptiveimmunityofpatientswithscarYANGui-chun,ANXin,ZHANGHai-yong,WANGRui-hai,PEIYin-hui,YUBo(DepartmentofPlasticSurgery,KailuanHospital,Tangshan063000,Hebei,China)Abstract:ObjectiveBycomparingthedifferencesofcellularandhumoralimmunitybetweencaseandcontrolgroup,theimmunityofpatientswithscarwasassessed,sothepossibleimmunitymechanismoftheformationscarwaspresumed・MethodslOlcasesofpatientswithscarweredividedinto3groups(mild,middleandheavygroup),50oneswhohavephysicalexaminedwereservedascontro1.TlymphocytesubtypesandcyotoxicityofCD8Tlymphocyteweredetected,andtheconcentrationofTNF-BsecretedbyCD8Tlymphocytewasdeterminedtoo.SerumwascollectedfothedetectionsofINF~randIL-4,bio-activitymethodandELISAwereperformedforthatpurposerespectively.ResultsThedifferencesofthepercentageofCD4Tsubtypeinmild,middle,heavyscargroupandcontrolweresignificantexceptthecomparisonsbetweencontrolandmildscargroup,middlescargroupandheavyscargroup,sodidthatinCD8Tsubtype・TheconcentraionofINF~rwassignificantlydifferentamongallthegroups・TheexpressionsofIL-4weredifferentexceptthecomparionofmildandmiddlescargroup・AboutthecytotoxicityofCD8Tlymphocyte,thedifferencesweresignificantexceptthecomparisionofmildandmiddlescargroupundertheratioofeffectandtargetcellwas5:1.ThereweresignificantdifferencesamongallthegroupsaboutthelevelofTNF-B.ConclusionComparedtothecontrolgroup,theadoptiveimmunitofpatientswithscarwasseentobeinanabnormalstate,namely,thecellularimmunityincreasedwhilethehumoralimmunitydecreased,andthistrendbecomesmoreobviouslywiththemoreseriousofscartissue・Thisindicatedthattheformationofscartissuemightberelatedtotheincreasmentofcellularimmunityandthedecreasmentofhumoralimmunity・Keywords:scar;Th1cytokine;Th2cytokime;CD8Tlymphocyte瘢痕（scar）是皮肤创伤修复和愈合过程的产物。目前有关瘢痕组织的适应性免疫学发山机制研究尚缺乏系统性，不能从整体水平阐述瘢痕的免疫学发生机制［1］。本研究通过研究瘢痕患者适应性免疫功能状态，探讨瘢痕的发山与机体适应性免疫应答功能Z间的关系,从而为瘢痕的免疫学防治奠定理论依据。1临床资料自2008年2月〜2009年9月于我科就诊的瘢痕患者101例为病例组，根据瘢痕病情严重程度分类的积分标准...