脓毒性休克患者淋巴细胞计数的临床意义分析

Clinical analysis of lymphocyte count in patients with septic shock

目的:进一步探索淋巴细胞(LC)计数在脓毒性休克患者救治中的临床意义。方法:回顾性分析2015-01—2019-07期间入住我院的39例脓毒性休克患者入院时的LC、C反应蛋白(CRP)、IL-6检测结果,同时对患者进行脓毒症相关性器官功能评分(SOFA)、多器官功能障碍评分(MODS)及急性生理与慢性健康评分(APACHEⅡ)。根据以上检测和评分结果对患者进行血管活性药物使用时间、呼吸机使用时间、留住ICU时间及预期死亡风险进行相关性分析。结果:患者入院时LC与CRP、IL-6、SOFA、MODS、APACHEⅡ、血管活性药物使用时间、呼吸机使用时间、留住ICU时间及预期死亡风险均呈现负相关性趋势。LC计数越低,CRP、IL-6、SOFA、MODS、APACHEⅡ评分就越高,同时LC计数越低,患者血管活性药物使用时间、呼吸机使用时间、留住ICU时间及血管活性药物使用时间就越长,预期病死率风险就越高。其中LC与SOFA、MODS、APACHEⅡ及预期病死率风险具有显著负相关性(P<0.05);死亡组与存活组相比较,CRP、IL-6、SOFA评分、MODS评分、血管活性药物使用时间、住ICU时间与预后明显负相关(P<0.05)。结论:LC计数可作为脓毒性休克患者预后的判断指标。

Objective:To investigate the clinical significance of the detection of peripheral blood lymphocyte count(LC)in patients with sepsis shock.Method:Thirty-nine cases with sepsis shock admitted to The Third People’s Hospital of Yunnan Province from January 2015 to July 2019 were retrospectively analyzed by detecting the level of LC,C-reactive protein(CRP)and interleukin-6(IL-6).At the same time,the prognostic values of sepsis-associated organ function score(SOFA),multiple organ dysfunction scores(MODS),as well as the acute physiology and chronic health evaluation II(APACHE II),were assessed.According to the above results,the relationship between the duration of usage of vasoactive agent,the time of mechanical ventilation,the ICU retention time and the risk of anticipated death were evaluated.Result:Correlation analysis showed that the LC levels were negatively correlated with CRP,IL-6,SOFA scores,MODS scores,APACHE-Ⅱscores,and correlated clinical indexes that include the duration of usage of vasoactive agent,the time of mechanical ventilation,the ICU retention time and the risk of anticipated death.Specifically,there was a significantly negative correlation between the LC levels and SOFA scores,MODS scores,and APACHE-Ⅱscores and the risk of anticipated death(P<0.05).Compared with survival group,IL-6,SOFA score,MODS score,APACHEⅡ,ICU and prognosis in death group are higher,while CRP,vascular active drug use time,ICU and prognosis of LC are lower in death group than those in survival group(P<0.05).Conclusion:LC can be used as a prognosis of septic shock patients.