: CIRCULATORY DISEASES: BASIC AND CLINICAL ASPECTS 616-092.18:612.017.11 – . . « . ( ) , . . - . , . . », , , (1- – ,2- – ). , . Cd14hiCd16+ Cd14dimCd16++) 1- 7- . . 1- Cd14hiCd16+. 3- ( Cd14hiCd16– , Cd14hiCd16+– , . SofA Cd14hiCd16– Cd14hiCd16+ . . 1- Cd14hiCd16– . : , , . . - ),3- – (Cd14hiCd16–, ( Cd14hiCd16– ) - Cd14hiCd16+ , - MONOCYTE SUBSETS IS A PREDICTOR Of SEVERE COMPLICATIONS Of SYSTEMIC INfLAMMATORY RESPONSE AfTER CORONARY BYPASS SURGERY V. G. MATVEEVA, A. S. GOLOVKIN, E. V. GRIGORIEV Federal State Budgetary Institution Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia Purpose.thestudywasexaminingofdynamicsbloodmonocytesubsetsfrompatientswithdifferentseverityofSystemicInlammatoryResponseSyndrome(SIRS)aftercoronarybypasssurgery. Materials and methods.Inretrospect,allofthepatientsinaccordancewithseverityoftheSIRSweredividedintothreegroups (1–uncomplicatedSIRS,2–complicatedSIRSwithcompensatedMultipleorgandysfunctionSyndrome(ModS),3–complicatedSIRS withdecompensatedModS).SIRSconirmedbyobjectiveclinicalandlaboratoryparameters,aswellasthepresenceofhypercytokinemia. Eachgroupwasestimateddynamicsofmonocytesubsets(Cd14hiCd16–,Cd14hiCd16+andCd14dimCd16++)bylaserlowcytometerbefore surgeryand1stand7thdayaftersurgery. Results.ontheirstdayaftersurgerypatientsoftheallgroupswasdetectedtheactivationofmonocyteswiththeredistributionof theirsubpopulationcomposition(decreaseintherelativecontentsubsetofCd14hiCd16–andincreaseinCd14hiCd16+).Atthesametime, patientsofthethirdgroup(SIRSwithdevelopedinthefuturedecompensatedModS)subsetCd14hiCd16–waslowerandCd14hiCd16+ washigherthanintheothergroups.foundcorrelationoftheSofAestimatesandtherelativeproportionsbloodmonocytesCd14hiCd16– andCd14hiCd16+. Conclusion.IntheirstdaysaftercoronarybypasssurgeryrelativeproportionsubsetsCd14hiCd16+andCd14hiCd16–maybediagnosticandprognosticmarkersofthesevereSIRSanddevelopedinthefuturedecompensatedModS. Key words: monocyte subsets, Systemic Inlammatory Response Syndrome, Multiple organ dysfunction Syndrome, prognostic marker. 5 : ( ) ( - [2]. ( . ( 50 % [4]. ) , - ) - ) . ( ). - , ( – – – 38 ° 20 12×10 9/ . – 36 ° , 90 / ; 4×109/ – - ; 10 %), [8], 14 CD16 , – [1, 2]. - [3] [1]. - , (IL-6, IL-8, TNF , IL-10) , , . - [2]. - CD14dimCD16++ . . . , 2010 . hi , - , , - , , [16]. . , , . - , : CD14hiCD16+, [14]. CD- , , [11, 13, 14]. CD14hiCD16+ , , , , dim ++ CD14 CD16 [18, 19]. CD14+CD16+, – , , ( , , , , . .) [19]. . , , [2]. - , 6 , . , . , - . . , . . , . . ( , ) – ( . 1). - - . , 19 ), 69 , – 62 (55– » 2012 . c ( ), ( ), ( ) - II–III I–II . . 45 %». APACHEII . Levy. - , - , : 1- – ). , 2- – , 3- – . . , : , . - , . , - POSSUM. Bone SOFA. ( , [5]. (50 « 2011 . : « , ... - [10]. . 67 3(69 , - (65–74), <0,05) (1- 59 (55–65), 2- 62 (54–68). . - 96 – 61 (80–112,5 (53–70 – 2 . ), ). 3. ( K3 7 , . -20 ° . ) ( . , , 18–20 : ) 2 . - 1 1- SOFA, APACHEII POSSUM 2 – 2- – - 3- – 0 1–3 4 0–5 5, 6–11 10, 12 1,2 % 4,9 % 20, - 24,9 % 0–2 2 2–4 – + +++ – + +++ 70 (68–79) % 65 (60–67) % 60 (58–67) % 7 : 4 FSC/SSC, SSC/CD45 . eBioscience (HumanTNF- HighSensitivityELISA, HumanIL-6 PlatinumELISA, HumanIL-10 PlatinumELISA). , . « »( ). CD14. 3 . CD16–FITC (IQTest, IsotypeIgG1), CD45–PC5 (IQTest, IsotypeIgG1), CD14–APC (IQTest, IsotypeIgG2 , BeckmanCoulter, USA). 3 . 30 . Invitrogen). PBS. 14hiCD16–, CD14hiCD16+ – CDCD14dimCD16+ ( .). Statistica 6.0. - (Wilcoxon). – , . 8 (Q1–Q3) (FS ) SSC ). (Spearman). ( ), 25 75 % . - , ( ) [2, 6, 9]. FACSCaliburBD . - (U- <0,05. (PBSpH= 7,2 (Gibco, CellQuestPro . CD16 CD14 - (SSC) SSC/ - - ( IL-6 ( 20 . 2). , IL-6 , CD45. CD14 CD16 ) . - . . , . . , . . 3- , IL-6 2- . – . IL-10 3- , ( - . IL-10 . 2). . 2). ( TNF ... . - 2 , ( 1- 7- I-II I (Q1–Q3) II-III II IL-6 ( / I-III III ) 1 (n= 31) 1,7 (0,52–2,36) <0,0001 38,62 (18,26–125,02) <0,0001 3,94 (0,8–8,66) 0,0001 2 (n= 30) 1,55 (0,57–2,15) 0,0001 29,06 (18,33–63,05) 0,0002 4,75 (1,7–8,43) 0,005 3 (n= 8) 1,88 (1,58–2,35) 0,0117 78,5 (49,8–126,2) 0,0277 9 (4,3–14,32) 0,0277 ## TNF ( / ) 1 0,234 (0,210–0,287) 0,0033 0,278 (0,255–0,366) 0,0043 0,244 (0,222–0,275) 0,9063 2 0,25 (0,238–0,272) 0,0843 0,271 (0,249–0,326) 0,0995 0,252 (0,238–0,27) 0,9375 3 0,281 (0,265–0,308) 0,0679 0,315 (0,283–0,394) 0,0679 0,256 (0,255–0,303) 0,4652 1 3,17 (2,50–4,25) <0,0001 11,20 (6,42–55,88) <0,0001 3,60 (2,70–4,67) 0,1808 2 3,84 (2,63–5,41) <0,0001 8,78 (5,3–30,8) <0,0001 4,22 (3,10–4,99) 0,6272 3 4,39 (2,15–5,72) 0,0117 72,15*/** (13,93–95,61) 0,0277 4,59 (3,80–5,71) 0,051 IL-10 ( = 0,035 ## 2- 2- / ) ; * = 0,049 . 1- ; ** = 0,013 3 , ( 7- 1I (Q1–Q3) II I–II III II–III CD14 CD16 hi I–III – 1 (n= 31) 85,8 (80,1–90,5) <0,0001 76,3 (73,3–80,8) 0,0003 85,3 (78–91,5) 0,581 2 (n= 29) 84,8 (80,1–88,8) 77,2 (69,3–85,5), n=4 0,0169 0,0080 83,8 (81–88,3) 80,2 (76,5–83,9), n=2 0,527 0,068 78,3 (73,5–85,9) 67,3*/** (60,7–68,7), n=4 CD14hiCD16+ 3 (n= 4) – – 1 4,7 (3,8–11,7) <0,0001 18,1 (13,9–23,3) <0,0001 5,8 (4,4–13,4) 0,052 2 6,3 (4,2–9,3) <0,0001 18,5 (11,4–23,8) 0,0002 9,4 (5,9–11,2) 0,0214 3 9,2 (8,1–13,6) 0,0680 29 #/## (26,3–30,9) – 11,4 (8,9–13,9) – 2,3 (1,5–3,7) <0,0001 3,9 (2,5–6) 0,0930 CD14dimCD16+ 1 5,3 (3,6–8,1) <0,0001 2 5,4 (4,2–10,3) <0,0001 2,4 (2–3,6) 0,0010 4,5 (2,8–7,8) 0,0068 3 10,5 (5,5–16,7) 0,069 2,7 (2,0–7,0) – 6,9 (4,3–9,5) – * = 0,007 1- 1- ; ## = 0,0177 ; ** = 0,0081 2- 2- . ; # = 0,0095 9 : , . SOFA CD14hiCD16– CD14hiCD16– ( - 4. ( . 3). 1 2), - (+0,25 –0,25). CD14hiCD16+, (r) 4 SOFA . , CD14hiCD16– - 3- , 1- 2- . - (%) SOFA ( ) CD14hiCD16– r= –0,25 ( = 0,046) CD14hiCD16+ r= +0,25 ( = 0,044) CD14dimCD16+ r= +0,14 ( = 0,283) CD14hiCD16+ ( . 3), 3- CD14hiCD16+ , CD14hiCD16+ ( 1. , - - . ) 2- . - IL-6 IL-10 - . CD14dimCD16+. . ( TNF - , ), , , ( – , CD14hiCD16+ [15] , . ), - . CD14hiCD16–. , . SOFA 10 TNF , IL-6, TNF IL-10 [7]. - 5–10 % CD14hiCD16–. , , , CD14hiCD16+ - , , . , . CD14hiCD16– - . . , . . , . . – . . [11]. CD14hiCD16+ . CD- 14hiCD16+ TNF , IL-1 , IL-6 [13]. - , » [11]. CD14hiCD16+ CD14hiCD16–, CD14hiCD16– - , CD14hiCD16+. , CD14 CD16+ CD14hiCD16– hi - . - SOFA . . [7], CD14hiCD16+ - . CD14hiCD16+ CD14 CD16+ 68,7 % CD14hiCD16–, ( CD14hiCD16+, hi CD14hiCD16+ ). - , CD14hiCD16– CD14hiCD16+, [12, 17, 18]. CD14hiCD16+. - (IL-6,IL-10). - , , . CD4 T- , « ... , - 26,3 % . . 1. . [ 2. C. 9–17. 2. . . 9–21. 3. . . [ 1. 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