Differences of platelet activation and T cell function in patients with sepsis with different prognosis
Objective:To investigate the difference of platelet activation and T cell function in patients with sepsis with different prognosis and the correlation with the risk of poor prognosis.Methods:Eighty-nine patients with sepsis from January 2020 to February 2023 were analyzed.According to whether the infection was controlled during hospitalization and the prognosis within 3 months after discharge,the patients were divided into two groups:good prognosis group(n=61)and poor prognosis group(n=28).The general clinical data such as sex,age,quick sequential organ failure assessment,platelet activation related serological markers such as platelet fac-tor 4(PF4),P-selectin and protein kinase C δ,platelet activation related membrane markers such as CD62p,CD40L and CD63,and T cell function related indexes such as CD4+T cell proportion,CD8+T cell proportion and CD4+T/CD8+T ratio were compared between the two groups.The differences of various indexes among patients with different prognosis were analyzed,and the risk factors of poor prognosis in patients with sepsis were screened by Spearman correlation analysis and multivariate logistic regression analysis.Results:The levels of serum PF4,P-selectin,platelet CD62p,CD40L and CD63 in patients with poor prognosis were significantly higher than pa-tients with good prognosis(P＜0.05).The proportion of CD4+T cells and CD4+/CD8+ ratio in patients with poor prognosis were significantly lower than patients with good prognosis(P＜0.05).The poor prognosis of pa-tients with sepsis was positively correlated with the levels of serum PF4,P-selectin,platelet CD62p,CD40L and CD63,and negatively correlated with the proportion of CD4+T cells and the ratio of CD4+/CD8+(P＜0.05).The increase of platelet CD62p and CD63 positive rate and the decrease of CD4+T cell proportion and CD4+/CD8+ratio were risk factors for poor prognosis in patients with sepsis(P＜0.05).Conclusion:There are signifi-cant differences in platelet activation and T cell function in patients with sepsis with different prognosis.The in-crease in the positive rate of platelet activation related membrane indexes such as CD62p and CD63 and the de-crease of T cell function indexes such as CD4+T cell proportion and CD4+/CD8+ ratio may indicate a poor prog-nosis of septic patients.Monitoring related indexes will be helpful to early evaluate the condition and prognosis of septic patients.
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