[Study on monocyte HLA-DR expression in critically ill patients after surgery].

Objective: To explore the HLA-DR expression on CD14(+) monocyte in peripheral blood of critically ill patients after surgery and observe its relationship with prognosis of patients.
Methods: HLA-DR expression on CD14(+) monocytes in peripheral blood was measured in critically ill patients after surgery (30 cases) by using flow cytometry on the day 1, 4 and 7 after entered the ICU, and were compared with those in the healthy volunteers (28 cases). APACHE II score, sepsis-related organ failure assessment (SOFA) score, age, sex and 28 d prognosis were recorded.
Results: The HLA-DR expression on CD14(+) monocyte in peripheral blood in critically ill patients after surgery were lower than that of healthy volunteers (P < 0.01). The CD14(+) monocyte HLA-DR expression on day 1 after entered ICU was not correlated with APACHE II score, SOFA and 28 d prognosis. However, compared with those with decreased HLA-DR expression, those with increased monocyte HLA-DR expression on day 7 had a better 28 d survival rate (P < 0.01).
Conclusions: In critically ill patients after surgery, the decreased HLA-DR expression on CD14(+) monocyte in peripheral blood on day 1 after entered ICU could not be regarded as a prognostic parameter, but it is significative to monitor the increased expression of HLA-DR on CD14(+) monocyte for evaluating the 28 d prognosis.