A clinical study on the prognostic evaluation of sepsis patients using T lymphocyte subsets combined with PD-1
Objective To detect the expression of PD-1,T lymphocyte subsets and some cytokines to evaluate the immune status and the prognosis of sepsis patients.Methods 68 patients who met the Sepsis 3.0 diagnostic criteria for sepsis and septic shock defined by theAmerican Society of Critical Care Medicine/European Society of Critical Care Medicine(SCCM/ESICM)in 2016 were divided into a sepsis group and a septic shock group based on their condition.Upon admission,the general clinical informations were recorded,and PD-1 was detected by ELISA,and peripheral blood was extracted for testing,including blood routine,lymphocyte subsets(CD4+T helper lym-phocytes,CD8+T suppressor lymphocytes),procalcitonin,interleukin-6,and hypersensitive C-reactive protein.Results There was no significant difference in the general data between the two groups(P＞0.05),but there was a statistical difference in the acute physiological and chronic health scores and sequential organ failure scores between the two groups(P＜0.05).The expression level of PD-1 in the septic shock group was higher than that in sepsis,and the difference was statistically significant(P＜0.05).But the lymphocyte count,CD4+,CD8+,CD4+/CD8+were lower in the sepsis group(P＜0.05).There were also statistically significant differences in the infection indicators procalcitonin,inflammation indicators interleukin-6,and hypersensitive C-reactive protein between the two groups(P＜0.05).The detection values of sepsis shock group were higher than those of sepsis group(P＜0.05).There was no statistically significant difference in total T lymphocytes between the two groups(P＞0.05).The ICU stay time,14 day mortality rate,and 28 day mortality rate of patients in the septic shock group were significantly higher than those in the septic shock group(P＜0.05).The expression level of PD-1 and CD4+T cells were independent risk factors for mortality in sepsis patients.Conclusion Patients with sepsis and septic shock exhibit early immunosuppression,while patients with septic shock have more severe immunosuppression and poorer prognosis.
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