T淋巴细胞亚群对脓毒症患者继发持续性炎症-免疫抑制-分解代谢综合征的评估价值  

Evaluation of T Lymphocyte Subsets in Sepsis Patients with Secondary Persistent Inflammation-Immunosuppression-Catabolism Syndrome

作　　者：余祖启 任胜勇 YU Zuqi;REN Shengyong(Department of Intensive Care Medicine,The First Affiliated Hospital of Zhengzhou University/Henan Provincial People's Hospital,Zhengzhou Henan 450000)

机构地区：[1]郑州大学人民医院/河南省人民医院重症医学科,河南郑州450000

出　　处：《医学临床研究》2025年第3期426-429,共4页Journal of Clinical Research

摘　　要：【目的】探讨T淋巴细胞亚群对脓毒症患者继发持续性炎症-免疫抑制-分解代谢综合征(PICS)的评估价值。【方法】196例脓毒症患者,根据患者是否发生PICS将其分为PICS组(n=67)与非PICS组(n=129)。比较两组患者的动脉血乳酸水平、免疫功能指标[T淋巴细胞亚群水平(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))]、炎症因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)、降钙素原(PCT)]水平、营养指标[血清总蛋白(TP)、白蛋白(ALB)、前白蛋白(PA)、血红蛋白(Hb)]。分析脓毒症患者继发PICS的影响因素,采用受试者工作曲线(ROC)评估T淋巴细胞亚群对患者发生PICS的预测价值。【结果】PICS组患者的动脉血乳酸、炎症因子水平低于非PICS组,T淋巴细胞亚群和营养指标水平均高于非PICS组(均P<0.05)。多因素分析显示,患者的动脉血乳酸、炎症因子水平、免疫功能和营养状态均是脓毒症患者合并PICS的重要影响因素(P<0.05),且T淋巴细胞亚群水平的联合检测对评估脓毒症患者继发PICS的曲线下面积(AUC)为0.965,高于各项单独指标评估(P<0.05)。【结论】T淋巴细胞亚群水平对脓毒症患者发生PICS具有较高的预测价值。【Objective】To explore the application value of T lymphocyte subsets in patients with sepsis and secondary persistent inflammation-immunosuppression-catabolism syndrome(PICS).【Methods】A total of 196 sepsis patients were included in the study.Based on whether patients had PICS,they were divided into the PICS group(n=67)and the non-PICS group(n=129).Arterial blood lactate level,immune function[T lymphocyte subset levels(CD3^(+),CD4^(+),CD4^(+)/CD8^(+))],inflammation markers[C-reactive protein(CRP),interleukin-6(IL-6),procalcitonin(PCT)],and nutritional indicators[serum total protein(TP),albumin(ALB),prealbumin(PA),hemoglobin(Hb)]were compared between the two groups.Multivariate analysis was used to identify the factors influencing the development of PICS in sepsis patients,and receiver operating characteristic(ROC)curves were used to evaluate the predictive value of T lymphocyte subsets in the occurrence of PICS.【Results】The PICS group had lower blood lactate and inflammatory factor levels than the non-PICS group,while T lymphocyte subsets and nutritional indicators were higher in the PICS group(all P<0.05).Multivariate analysis showed that blood lactate,inflammatory levels,immune function,and nutritional status were important factors influencing the development of PICS in sepsis patients(P<0.05).The combined detection of T lymphocyte subsets showed an area under the curve(AUC)of 0.965 for predicting PICS in sepsis patients,which was higher than the individual tests of T lymphocyte subsets(P<0.05).【Conclusion】T lymphocyte subset levels have high predictive value for the occurrence of PICS in sepsis patients.

关 键 词：脓毒症 T淋巴细胞亚群 免疫耐受 

分 类 号：R631.1[医药卫生—外科学]