[Clinical value of monitoring CD14+ monocyte human leukocyte antigen (locus) DR levels in the early stage of sepsis].
OBJECTIVE
To explore the relationship of monitoring CD14(+) monocyte human leucocyte antigen (locus) DR (HLA-DR) and the outcome in the early stage of sepsis.


METHODS
Thirty-six definitely diagnosed septic patients in intensive care unit (ICU) were included. CD14(+) monocyte HLA-DR levels were detected by flow cytometer on the first day of the study, and acute physiology and chronic health evaluation II (APACHE II) scores were evaluated. Their clinical values in predicting the outcome of the disease were assessed through correlation analysis.


RESULTS
Among 36 sepsis patients CD14(+) monocyte HLA-DR level<30% was found in 6 patients (16.67%). The average APACHE II score was 24.17+/-4.45 (r=0.212, P=0.687), all of them die, CD14(+) monocyte HLA-DR level <40% was 27.78% (10/36), the scores of APACHE II score was 23.50+/-4.30 (r=-0.0251, P=0.484), and the mortality rate was 80% (8/10).


CONCLUSIONS
CD14(+) monocyte HLA-DR level <30% is an immunosuppressive index. In predicting the outcome of sepsis, it might be better than APACHE II scores. Immunosuppression is primarily found in the early stage of sepsis, suggesting that the classical compensatory anti-inflammatory response syndrome (CARS) hypothesis needs to be revised and improved.
Su
Lei
L
Department of Gastroenterology, South Hospital, South Medical University, Guangzhou 510010, Guangdong, China.
Zhou
Dian-yuan
DY
Tang
You-qing
YQ
Wen
Qiang
Q
Bai
Tao
T
Meng
Fan-su
FS
Tang
Li-qun
LQ
Duan
Peng-kai
PK
D018806:APACHE; D000328:Adult; D000368:Aged; D005260:Female; D006684:HLA-DR Antigens / Q000032:analysis*; D006801:Humans; D007108:Immune Tolerance; D007362:Intensive Care Units; D018950:Lipopolysaccharide Receptors / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology / Q000378:metabolism; D011379:Prognosis; D018805:Sepsis / Q000276:immunology*; D055815:Young Adult
D006684:HLA-DR Antigens; D018950:Lipopolysaccharide Receptors