Peripheral blood CD8+effector memory T cells in the diagnosis of sepsis
Objective To explore the value of CD8+T cell subsets in the diagnosis of sepsis.Methods A prospective study was conducted on 30 sepsis and 30 non-sepsis patients admitted to the ICU of Daping Hospital,Ar-my Medical University from Mar.2021 to Mar.2022.There are 40 males and 20 females aged 29-70(mean 55.4)years,with 16 trauma patients(7 road traffic injuries,5 falls from height,3 crush injuries,and 1 sharp instrument in-jury).Peripheral blood was sampled on the 1st,3rd,and 5th day of ICU admission and analyzed by flow cytometry to detect the proportions of T lymphocytes and CD8+T cell subsets,respectively naive,memory,and effector T cells(CD8+TCM,CD8+TEM and CD8+Naive T).Comparison between sepsis and non-sepsis patients was performed:repeated measurement data were analyzed using analysis of variance(ANOVA)for repeated measurement data,and specific time point comparisons by multiple comparison methods.Univariate logistic regression analysis was used to identify CD8+T cell subsets that were associated with sepsis occurrence,ROC curves to evaluate their diagnostic ef-ficacy for sepsis,and Pearson correlation test to analyze their correlation with sepsis severity.Results On the 1st,3rd,and 5th day of ICU admission,the proportions of CD3+T cells in sepsis patients were significantly lower than those in non-sepsis patients(54.32％±16.44％vs.67.13％±12.90％,59.42％±14.49％vs.68.12％±12.95％,58.81％±17.47％vs.69.68±10.87％,all P＜0.05);further analysis showed similar results for CD8+TEM(25.45％±10.55％vs.39.51％±12.59％,27.38％±11.19％vs.39.81％±14.24％,28.56％±12.38％vs.38.97±12.89％,all P＜0.05).In addition,the proportions of CD4+T cells and CD8+Naive T in sepsis patients on 3rd day of ICU admission were significantly higher than those in non-sepsis patients(64.88％±10.94％vs.57.51％±13.49％,22.85％±17.00％vs.14.47±7.32％,both P＜0.05).Logistic regression analysis showed that the proportions of CD3+T cells and CD8+TEM subsets,as well as plasma procalcitonin(PCT)and C-reactive pro-tein(CRP)levels were risk factors for sepsis.The AUC of PCT level combined with the proportion of CD8+TEM in the diagnosis of sepsis was 0.890(0.775-0.995).Conclusion The combination of the proportion of CD8+TEM and plasma PCT level has good efficacy in the early diagnosis of sepsis.
NETL
NSTL
万方数据
维普
