The changes andc linical significance of CD69, HLA-DR in target glucose contor l therapy for septic patients

doi:10.3969/j.issn.1002-1949.2015.08.001

Abstract：Objective To explore the effect and significance of CD69 and HLA-DR in the early target glucose control therapy for the septic patients.Methods Ninety septic patients were randomly divided into three groups: target glucose control A group ( n=30, glucose control in 4.4~6.1 mmol/L), target glucose control B group (n=30, glucose control in 6.2~8.3 mmol/L) and target glucose control C group (n=30, glucose control in 8.4 ~10.0 mmol/L).Target blood glucose was given on admission.The expression level of CD69/HLA-DR was determined on day 0 ( on admission) and on day 1, day 3 and day 7 after admission by flow cytometry.APACHEⅡscore, 28 days ( d) mortality, the MODS and hypoglycemia incidence rate were also recorded and compared.Results Compared with day 0, the level of CD69 and HLA -DR were significantly raised in group A ( P <0.05);Compared with day 0, CD69 expression level in group B was significantly increased on day 1 and day 7, HLA -DR expression level was significantly increased on day 1 and day 7 ( P <0.05 );Compared with day 0, CD69 and HLA-DR expression was reduced after the first rising trend, CD69 expression level was significantly increased on day 3 and day 7, HLA -DR expression level was significantly increased on day 1 and day 7 (P<0.05).In the three groups, the Score of APACHEⅡon day 1, day 3 and day 7 were reduced than that on day 0, and the difference was statistically significant (P<0.05);The APACHEⅡscore on day 7 in group A was significantly lower than that in group B and C (P<0.05).The 28 days( d) mortality and the MODS incidence rate of group A was lower than group B, C, but the difference was not significant (P>0.05).The hypoglycemia incidence rate was not significant among the three groups ( P>0.05).Conc lusion Target glucose control management at 4.4~6.1 mmol/L results in increased level of CD69 and HLA- DR, which helps to terminate the immune paralysis and immune disorders in ill patients with sepsis and promotes the recovery of immunity homeostasis.