侵袭性真菌致血流感染患者检测T细胞CD4^(+)、sCD40、CD154的临床价值  

Clinical Value of Detecting CD4^(+)T Cells,sCD40,and CD154 in Patients with Invasive Fungal Bloodstream Infections

作　　者：李存辉 唐万香 罗成丽 LI Cunhui;TANG Wanxiang;LUO Chengli(The Second People's Hospital of Huangzhong District,Xining City,Qinghai Xining 811600)

机构地区：[1]西宁市湟中区第二人民医院,青海西宁811600

出　　处：《深圳中西医结合杂志》2024年第20期22-25,F0003,共5页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的:探究侵袭性真菌致血流感染患者检测外周血T细胞簇分化抗原(CD)4+、sCD40、CD154的临床价值。方法:以2021年1月至2023年12月西宁市湟中区第二人民医院收治的131例侵袭性真菌致血流感染患者为感染组,并以同期73例体检健康者为对照组,检测CD4^(+)T细胞在淋巴细胞中的比例、CD4^(+)T细胞表面CD154及sCD40水平。将感染组分为重症组及轻症组,分析CD4^(+)、sCD40、CD154与病情严重程度的关系;所有患者均随访28 d,根据患者生存情况将其分为死亡组及生存组,分析CD4^(+)、sCD40、CD154对患者预后的预测价值。结果:感染组CD4^(+)T细胞在淋巴细胞中的比例及CD4^(+)T细胞表面CD154表达高于对照组,sCD40水平高于对照组,且重症组均高于轻症组,死亡组均高于生存组,差异均具有统计学意义(P<0.05);CD4^(+)、sCD40、CD154联合检测预测患者预后的受试者工作特征(ROC)曲线下面积(AUC)为0.866,大于CD4^(+)、sCD40及CD154单独检测(0.771、0.754、0.705),差异具有统计学意义(P<0.05);CD4^(+)≥51.17%患者的累积生存率低于CD4^(+)<51.17%患者,sCD40≥509.66 pg·mL-1患者的累积生存率低于sCD40<509.66 pg·mL-1患者,CD154≥43.42%患者的累积生存率低于CD154<43.42%患者,差异均具有统计学意义(P<0.05)。结论:侵袭性真菌致血流感染患者T细胞CD4^(+)、sCD40、CD154水平显著升高,各指标联合检测对患者预后具有预测价值。Objective To investigate the clinical value of peripheral blood detecting cluster of differentiation(CD)4^(+)T cells,soluble CD40(sCD40),and CD154 in patients with invasive fungal bloodstream infections.Methods A total of 131 patients with invasive fungal bloodstream infections admitted to the Second People’s Hospital of Huangzhong District,Xining City from January 2021 to December 2023 were included in the infection group,and 73 healthy individuals undergoing physical examination during the same period were included in the control group.The proportion of CD4^(+)T cells in lymphocytes,CD154 expression on CD4^(+)T cell surfaces,and the level of sCD40 were measured.The patients in the infection group were divided into severe and mild groups to analyze the relationship between CD4^(+),sCD40,CD154 and disease severity.All patients were followed up for 28 days and divided into death and survival groups based on their survival status to analyze the predictive value of CD4^(+),sCD40,and CD154 on prognosis.Results The proportion of CD4^(+)T cells in lymphocytes and CD154 expression on CD4^(+)T cell surfaces in the infection group were higher than those in the control group,and the level of sCD40 was also higher than that in the control group.Moreover,these values were higher in the severe group than in the mild group and higher in the death group than in the survival group,with statistically significant differences(P<0.05).The area under the receiver operating characteristic(ROC)curve(AUC)for the combined detection of CD4^(+),sCD40,and CD154 to predict patient prognosis was 0.866,which was greater than the AUC for the individual detection of CD4^(+)(0.771),sCD40(0.754),and CD154(0.705),with statistically significant differences(P<0.05).The cumulative survival rate of patients with CD4^(+)≥51.17%was lower than that of patients with CD4^(+)<51.17%,the cumulative survival rate of patients with sCD40≥509.66 pg·mL-1 was lower than that of patients with sCD40<509.66 pg·mL-1,and the cumulative survival rate of patients

关 键 词：侵袭性真菌血流感染 簇分化抗原 T细胞 

分 类 号：R519[医药卫生—内科学]