S-ChE联合T细胞表面PD-1水平对脓毒症患者病情预后状况评估的价值

The effect of S-ChE combined with T cell surface PD-1 level on the evaluation of the prognosis of patients with sepsis

目的观察脓毒症患者血清胆碱酯酶(S-ChE)和T细胞程序性死亡分子-1(PD-1)以及炎症因子水平,并分析其与患者预后关系。方法选取2018年8月—2021年5月在我院接受治疗的脓毒症患者为研究对象,同时选取同期在我院接受体检的健康人群为对照组。根据脓毒症患者的预后分为存活组和死亡组。比较脓毒症组和对照组、脓毒症存活组和死亡组患者S-ChE、PD-1水平和炎症因子水平的差异,并分析与患者预后的关系。结果脓毒症患者的S-ChE水平低于对照组,PD-1水平高于对照组(P<0.05)。脓毒症患者的CRP、PCT水平高于对照组,CD3^(+)T、CD3^(+)CD4^(+)T和CD4^(+)CD8^(+)T水平低于对照组(P<0.05)。死亡组患者的S-ChE水平低于存活组,PD-1水平高于存活组(P<0.05)。死亡组患者的CRP、PCT水平高于存活组,CD3^(+)T、CD3^(+)CD4^(+)T和CD4^(+)CD8^(+)T水平低于存活组(P<0.05)。脓毒症患者S-ChE、PD-1水平呈负相关,(P<0.05)。脓毒症患者的SChE与CRP、PCT水平负相关,与CD3^(+)T、CD3^(+)CD4^(+)T、CD4^(+)CD8^(+)T水平正相关(P<0.05)。脓毒症患者的PD-1与CRP、PCT水平正相关,与CD3^(+)T、CD3^(+)CD4^(+)T、CD4^(+)CD8^(+)T水平负相关(P<0.05)。S-ChE、PD-1预测脓毒症患者预后的AUC值为0.725(95%CI:0.605~0.825)、0.706(95%CI:0.585~0.809),P<0.05。结论脓毒症患者的S-ChE水平较低,PD-1水平较高,且与炎症因子水平和患者的预后相关。

Objective To analyze the levels of serum cholinesterase(S-ChE),programmed death 1(PD-1)and inflammatory factors in patients with sepsis,and analyze the relationship between them and the prognosis of patients.Methods Patients with sepsis treated in our hospital from August 2018 to May 2021 were selected as the research subjects,and healthy people who received physical examinations in our hospital during the same period were selected as the control subjects.The differences in the levels of S-ChE,PD-1 and inflammatory factors between the sepsis group and the control group,the sepsis survival group and the death group were compared,and their relationship with the prognosis of the patients were analyzed.Results The level of S-ChE in patients with sepsis was lower than that of the control group,and the level of PD-1 was higher than that of the control group(P<0.05).The CRP and PCT levels of sepsis patients were higher than those of the control subjects,and the levels of CD3^(+)T,CD3^(+)CD4^(+)T and CD4^(+)CD8^(+)T were lower(P<0.05).The S-ChE level of the death group was lower than that of the survival group,and the PD-1 level was higher than that of the survival group(P<0.05).The levels of CRP and PCT in the death group were higher than those in the survival group,and the levels of CD3^(+)T,CD3^(+)CD4^(+)T and CD4^(+)CD8^(+)T were lower than those in the survival group(P<0.05).The levels of S-ChE and PD-1 in sepsis patients were negatively correlated(P<0.05).S-ChE level in patients with sepsis was negatively correlated with CRP and PCT levels,and positively correlated with CD3^(+)T,CD3^(+)CD4^(+)T,and CD4^(+)CD8^(+)T levels(P<0.05).PD-1 level in patients with sepsis was positively correlated with CRP and PCT levels,and negatively correlated with CD3^(+)T,CD3^(+)CD4^(+)T,and CD4^(+)CD8^(+)T levels(P<0.05).The AUC values of S-ChE and PD-1 predicting the prognosis of patients with sepsis were 0.725(95%CI:0.605~0.825),0.706(95%CI:0.585~0.809),P<0.05.Conclusions Patients with sepsis had lower level of S-ChE and higher level of PD-1,which were related to the levels of inflammatory factors and the prognosis of patients.