[Relationship between immune imbalance and sthenia-asthenia syndromes in patients suffering from severe intra-abdominal infection].
OBJECTIVE
To explore the characteristics of immune imbalance in patients with multiple organ dysfunction syndrome (MODS) induced by severe intra-abdominal infection and its relationship with changing of TCM sthenia-asthenia syndrome.


METHODS
Forty-six patients with MODS induced by severe intra-abdominal infection and treated with etiological and syndrome differentiation of integrative medicine were observed in succession. Patients' peripheral blood levels of interleukin-6/interleukin-10 ratio (IL-6/IL-10), human leukocyte antigen DR site (HLA-DR), helper T lymphocyte1/2 ratio (Th1/Th2), and the regulatory T lymphocyte (Treg) were measured on the 1st, 3rd and 7th day of the research respectively. And the distribution laws of TCM syndrome types, sthenia (S), asthenia (A), and mingled sthenia/asthenia (M), in patients were observed as well.


RESULTS
IL-6/IL-10 ratio at all the testing time points showed insignificant difference in patients of types S and M, while in those of type A, it was more lowered on the 7th day than that on the 1st day. HLA-DR lowered to <30% on the 7th day in all patients of type A and showed significant difference to that on the 1st day (P <0.05), while HLA-DR <30% was not found in all patients of types S and M. Th1/Th2 ratio in patients of types S and A was insignificant different at the foremost 3 days, but lowered significantly on the 7th day, while in patients of type M, it was unchanged in all the 7 days of observation. Treg level was unchanged in the foremost 3 days in patients of types S and M, while in those of type A, it raised on the 3rd day, but no raising was found in the subsequent 4 days. Comparisons of various indexes detected at corresponding time points respectively among patients with various syndrome types showed that, for levels of IL-6/IL-8, HLA-DR, and Th1/Th2, the sequence was S>M>A; and for Treg, it was A>M>S.


CONCLUSIONS
In the pathological process of MODS induced by severe intra-abdominal infection, the index IL-6/IL-10, reflecting the balance of the pro-/anti-inflammatory cytokines and the indexes HLA-DR, Th1/Th2 and Treg reflecting the immune function, all can exactly reflect the TCM asthenia-sthenia syndrome types. The sequence in patients of various syndrome types for levels of IL-6/IL-10, HLA-DR and Th1/Th2, is S> M>A, but for Treg it is the inverse, as A>M>S.
Fu
Qiang
Q
Surgical Department of Tianjin Nankai Hospital, Tianjin Medical University, Tianjin.
Cui
Nai-Qiang
NQ
Yu
Wen-Li
WL
D000293:Adolescent; D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D006684:HLA-DR Antigens / Q000276:immunology; D006801:Humans; D015850:Interleukin-6 / Q000276:immunology; D016209:Interleukin-8 / Q000378:metabolism; D008516:Medicine, Chinese Traditional; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000150:complications / Q000188:drug therapy / Q000276:immunology*; D010538:Peritonitis / Q000150:complications / Q000188:drug therapy / Q000276:immunology*; D018805:Sepsis / Q000150:complications / Q000188:drug therapy / Q000276:immunology* / Q000378:metabolism; D050378:T-Lymphocytes, Regulatory / Q000276:immunology; D018417:Th1 Cells / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology; D016711:Yang Deficiency / Q000276:immunology*; D055815:Young Adult
C508606:CXCL8 protein, human; D006684:HLA-DR Antigens; C508600:IL6 protein, human; D015850:Interleukin-6; D016209:Interleukin-8