Expression and clinical significance of PD-L1,LAG-3,and inflammatory factors in the serum of patients with pulmonary infection complicated by sepsis
Objective To investigate the expression levels and clinical significance of programmed death-ligand 1(PD-L1),lymphocyte activating gene 3(LAG-3),and inflammatory factors in the serum of patients with pulmonary infection complicated by sepsis.Methods 96 patients with pulmonary infection complicated by sepsis admitted to Honghu Traditional Chinese Medicine Hospital from June 2021 to July 2023 were retrospectively selected as the observation group,according to their prognosis of survival status,they were divided into 68 cases in the survival group and 28 cases in the death group,and 110 healthy people who had medical checkups in the same period of time in our hospital were used as the control group.Serum PD-L1,LAG-3,interleukin(IL)-6,IL-8,IL-10,procalcitonin(PCT),C-reactive protein(CRP),and other inflammatory factors levels were examined on days 1,3,5,and 7 of admission in the observation group,and Acute Physiology And Chronic Health EvaluationⅡ(APACHEⅡ)score and Sequential Organ Failure Assessment(SOFA)score were used to score the patients with pulmonary infections complicated by sepsis in each group;the correlation between PD-L1,LAG-3,inflammatory factors and APACHEⅡ,SOFA scores in patients with pulmonary infection complicated by sepsis was analyzed using Spearman method;the factors affecting the prognosis of patients with pulmonary infection complicated by sepsis were analyzed using Logistic regression curves;the prognostic value of serum PD-L1,LAG-3,and inflammatory factor levels in patients with pulmonary infection complicating sepsis was analyzed using the receiver operating characteristic(ROC)curve.Results Serum levels of PD-L1,LAG-3 with IL-6,IL-8,PCT,CRP,APACHEⅡand SOFA scores were significantly higher in the observation group compared to the control group(t=18.878,31.675,47.256,17.007,36.931,46.249,25.472,35.589,P<0.05).The serum levels of PD-L1,IL-6,IL-8,CRP,scores of APACHEⅡ,and SOFA in patients with pulmonary infection complicated by sepsis began to increased on the 3rd day of admission,decreased on the 5th day,with a statistically significant difference from the 1st day on the 7th day of admission(F=45.102,291.957,38.741,51.782,23.215,100.872,P<0.05).The levels of serum PD-L1,LAG-3,and inflammatory factors in the observation group were positively correlated with APACHEⅡand SOFA scores(r=0.557,0.316,0.428,0.501,0.168,0.382,0.517,0.383,0.531,0.405,0.392,0.344,0.582,0.446,P<0.05).The serum levels of PD-L1,IL-6,IL-8,PCT,CRP,APACHEⅡ,and SOFA in the survival group were obviously lower than those in the death group(t=5.234,7.944,9.405,34.105,4.625,5.806,3.745,P<0.05).PD-L1,IL-8,CRP levels,and APACHEⅡand SOFA scores were independent risk factors for the prognosis of patients with pulmonary infection complicated by sepsis(OR=2.017,2.058,0.319,2.331,2.252,P<0.05).The combined prediction of PD-L1,IL-8,and CRP(0.987)was higher than that of individual prediction(0.882,0.897,0.874),which had a higher predictive value.Conclusion Patients with pulmonary infection complicated by sepsis exhibit elevated levels of PD-L1,LAG-3,and inflammatory factors,positively correlating with disease severity scores.Combined assessment of PD-L1,IL-8,and CRP provides valuable prognostic information in these patients.
Pulmonary infection complicated with sepsisProgrammed death-ligand 1Lymphocyte activation gene-3Inflammatory factorsPrognosis
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