摘要
目的:探讨脓毒症患者淋巴细胞亚群及其比值的变化参与免疫调节的意义.方法:这是一项单中心、横断面研究,研究对象为南京医科大学附属明基医院2020年1月-2022年3月收治的55例脓毒症患者和同期招募的50名年龄匹配的健康对照组.根据脓毒症和脓毒症休克的定义,将55例脓毒症患者进一步分为脓毒症组(39例)和脓毒症休克组(16例).通过流式细胞仪定量外周血中CD4+T淋巴细胞、CD8+T淋巴细胞、B淋巴细胞和NK细胞.结果:脓毒症组的CD8+T淋巴细胞、NK细胞百分比均低于对照组(P＜0.05);脓毒症休克组的NK细胞百分比显著低于对照组(P＜0.05).脓毒症组的B淋巴细胞百分比、CD4+T/CD8+T、B/NK显著高于对照组和脓毒症休克组(P＜0.05).脓毒症组的CD8+T淋巴细胞百分比、T/B、CD4+T/B、CD8+T/B显著低于对照组和脓毒症休克组(P＜0.05).B淋巴细胞百分比、CD4+T/CD8+T、T/NK、CD4+T/NK、CD8+T/NK和B/NK在脓毒症诊断中的AUC分别为0.609、0.560、0.671、0.645、0.602和0.680,其临界值分别为18.6、1.57、4.89、3.05、2.18 和 1.16.T 淋巴细胞百分比、CD8+T 淋巴细胞百分比、T/B、CD4+T/B、CD8+T/B 和CD8+T/NK在脓毒症休克诊断中的AUC分别为0.649、0.739、0.680、0.600、0.725和0.628,其截断值分别为73.7、26.8、6.25、3.57、2.26和4.28.结论:脓毒症患者的免疫表达模式不是淋巴细胞数量的简单减少,因为淋巴细胞亚群功能比率的变化可能在脓毒症的进展中更为关键.
Abstract
Objective:To explore the significance of the changes of lymphocyte subsets and their ratios in pa-tients with sepsis in immune regulation.Methods:This was a single-center,cross-sectional study.The subjects of the study were 55 sepsis patients admitted to our hospital from January 2020 to March 2022 and 50 age-matched healthy controls recruited.According to the definition of sepsis and septic shock,patients with sepsis were further divided into sepsis group(39 cases)and septic shock group(16 cases).CD4+T lymphocytes,CD8+T lympho-cytes,B lymphocytes and NK cells in peripheral blood were quantified by flow cytometry.Results:The percenta-ges of CD8+T lymphocytes and NK cells in the sepsis group were significantly lower than those in control group(P＜0.05).The percentage of NK cells in septic shock group was significantly lower than that in control group(P＜0.05).The percentage of B lymphocytes,CD4+T/CD8+T,and B/NK in the sepsis group were significantly higher than those in control group and septic shock group(P＜0.05).The percentage of CD8+T lymphocytes,T/B,CD4+T/B,and CD8+T/B in sepsis group were significantly lower than those in the control group and septic shock group(P＜0.05).The AUC of B lymphocyte percentage,CD4+T/CD8+T,T/NK,CD4+T/NK,CD8+T/NK,and B/NK in the diagnosis of sepsis were 0.609,0.560,0.671,0.645,0.602,and 0.680,respectively,with the critical values of 18.6,1.57,4.89,3.05,2.18,and 1.16,respectively.The AUC of T lymphocyte per-centage,CD8+T lymphocyte percentage,T/B,CD4+T/B,CD8+T/B,and CD8+T/NK in the diagnosis of septic shock were 0.649,0.739,0.680,0.600,0.725,and 0.628,respectively,with the cutoff values of 73.7,26.8,6.25,3.57,2.26,and 4.28,respectively.Conclusion:The pattern of immune expression in patients with sepsis is not a simple decrease in the number of lymphocytes,as changes in the functional ratio of lymphocyte subsets may be more critical in the progression of sepsis.
维普
万方数据