脓毒症患者血T淋巴细胞亚群、血清炎症因子的变化与疾病早期严重程度预后的临床研究

Clinical study of changes in T lymphocyte subsets and serum inflammatory factors in patients with sepsis and their correlation with disease severity and prognosis

目的研究脓毒症患者血T淋巴细胞亚群、血清炎症因子的变化与疾病早期严重程度、预后的关系。方法选择2021年7月至2022年9月九江市第一人民医院收治的78例脓毒症患者作为观察组,按照病情严重程度分为脓毒血症组(n=64)与脓毒性休克组(n=14),另选取同期健康体检者30例作为对照组。对各组血T淋巴细胞亚群(CD3、CD4、CD8、CD4/CD8)、白细胞计数(WBC)、血小板(PLT)、C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)水平进行检测,并记录患者SOFA评分,分析各指标与SOFA评分的关系。结果脓毒血症组与脓毒性休克组的CD3、CD4、CD8低于对照组,CD4/CD8、WBC、CRP、PCT、IL-6高于对照组,差异有统计学意义(P<0.05);脓毒性休克组的PLT低于对照组,差异有统计学意义(P<0.05);脓毒血症组的CD4/CD8高于脓毒性休克组,CRP、PCT、IL-6低于脓毒性休克组,差异有统计学意义(P<0.05)。脓毒血症组的SOFA评分低于脓毒性休克组,差异有统计学意义(P<0.05)。Pearson相关性分析显示,CD4/CD8与SOFA评分呈负相关,CRP、PCT、IL-6与SOFA评分均呈正相关(r=-0.635、0.493、0.621、0.573,P<0.05)。结论血T淋巴细胞亚群、血清炎症因子在脓毒症患者中呈异常表达状态,且血CD4/CD8、CRP、PCT、IL-6均与SOFA评分密切相关,临床检测价值较高。

Objective To study the changes of T lymphocyte subsets and serum inflammatory factors in patients with sepsis and their relationship with disease severity and prognosis.Methods A total of 78 patients with sepsis admitted to the First People's Hospital of Jiujiang City from July 2021 to September 2022 were selected as the observation group.They were divided into sepsis group(n=64)and septic shock group(n=14)according to the severity of the condition.In addition,30 healthy individuals in the same period were selected as the control group.The levels of blood T lymphocyte subsets(CD3,CD4,CD8,CD4/CD8),leukocyte count(WBC),platelets(PLT),C-reactive protein(CRP),procalcitonin(PCT),and interleukin-6(IL-6)in each group were measured,and the scores of patients with sequential organ failure assessment(SOFA)scores were recorded,and the relationship between each index and SOFA scores was analyzed.Results The levels of CD3,CD4,and CD8 in the sepsis group and septic shock group were lower than those in the control group,and the levels of CD4/CD8,WBC,CRP,PCT,and IL-6 were higher than those in the control group,with statistically significant differences(P<0.05).The PLT in the septic shock group was lower than that in the control group(P<0.05).the levels of CD4/CD8 in the sepsis group were higher than those in the septic shock group,while the levels of CRP,PCT,and IL-6 were lower than those in the septic shock group,with statistically significant differences(P<0.05).The SOFA score in the sepsis group was lower than that in the septic shock group(P<0.05).Pearson correlation analysis showed that CD4/CD8 was negatively correlated with SOFA scores,while CRP,PCT,IL-6 were positively correlated with SOFA scores(r=-0.635,0.493,0.621,0.573,P<0.05).Conclusion Blood T lymphocyte subsets and serum inflammatory factors are abnormally expressed in patients with sepsis,and blood CD4/CD8,CRP,PCT,and IL-6 are closely related to SOFA scores,with high clinical detection value.