脓毒症患者T淋巴细胞亚群水平与APACHEⅡ评分的关系

Relationship between T-lymphocyte Subset Levels and APACHE Ⅱ Score in Sepsis

目的探讨脓毒症患者T淋巴细胞亚群水平与APACHEⅡ评分的相关性。方法采用流式细胞仪测定60例脓毒症患者(脓毒症组)和40例同期住院的非脓毒症患者(对照组)的外周血CD4+T、CD8+T细胞水平,并计算CD4+T/CD8+T细胞比值和APACHEⅡ评分。按疾病转归将60例脓毒症患者分成死亡组(n=22)和存活组(n=38),比较上述检测指标水平。结果脓毒症组的CD4+T、CD4+T/CD8+T细胞水平明显低于对照组,差异有统计学意义(P<0.01);死亡组患者CD4+T、CD4+T/CD8+T细胞水平明显低于存活组,差异有统计学意义(P<0.01)。结论脓毒症患者APACHEⅡ评分与外周血CD4+T(r=-0.474,P<0.01)和CD4+T/CD8+T细胞比值(r=-0.425,P<0.01)呈显著负相关。

Objective To investigate the relationship between T-lymphocyte subset level and APACHE Ⅱ score in sepsis. Methods Flow cytometry was used to measure the peripheral levels of CD4^＋T and CD8^＋T between 60 cases of sepsis and 40 cases of non-sepsis at same stage,and the ratio of CD4^＋T to CD8^＋T and APACHE Ⅱ score were calculated. According to the prognosis,60 eases of sepsis were divided into the dead group（n=22）and survival group（n=38）, and the above-mentioned indices were compared. Results The levels of CD4^＋T and CD4^＋T/ CD8^＋T ratio were markedly lower in the sepsis group than those in the control group（P〈0.01 ）. The levels of the CD4^＋T and CD4^＋T/CD8^＋T ratio were markedly lower in the dead group than those in the survival group（P〈0.01 ）. The APACHE Ⅱ score was negatively correlated with the peripheral CD4^＋T level （r=-0.474,P〈0.01）and CD4^＋T/CD8^＋T ratio （r=-0.425 ,P〈0.01 ）in sepsis. Conclusion The peripheral CD4^＋T level proves to decrease considerably, and is closely related to the severity and prognosis of sepsis.