The clinical diagnostic value of T cell activation spectrum in distinguishing sepsis caused by different pathogens
Objective To explore the clinical diagnostic value of T cell activation spectrum in distinguishing sepsis caused by different pathogens.Methods A total of 100 sepsis patients who received treatment in our department from January 2020 to January 2023 were selected as the sepsis group,and 37 healthy volunteers who underwent physical exam-inations in the outpatient department were selected as the control group.The sepsis group was divided into Gram negative group(Ggroup,n=46)and Gram positive group(G+group,n=54)based on the patient's pathogen detection results upon ad-mission.The expressions of T lymphocytes and surface co-stimulatory molecules in peripheral blood were detected with flow cytometry,and the subject operating curve(ROC)was used to evaluate the ability of CD38+HLA-DR+T cells to dif-ferentiate between G-sepsis and G+sepsis.Results The proportion of CD4+CD38+CD69+T cells and CD8+CD38+CD69+T cells in peripheral blood of G-group and G+group were higher than those of the control group(all P＜0.05).There were no statistically significant difference in the proportion of CD4+CD38+CD69+T cells and CD8+CD38+CD69+T cells between the two groups(all P＞0.05).Compared with the control group,the expression levels of CD4+CD38+HLA-DR+and CD8+CD38+HLA-DR+in peripheral blood of each subgroup of sepsis increased(all P＜0.05),and the degree of increase in the G-sepsis group was higher than that in the G+sepsis group(P＜0.05).When distinguishing between G-sepsis and G+sepsis,the AUC of CD4+CD38+HLA-DR+T cells was 0.901(95％CI:0.837-0.965),with a specificity of 0.867(95％CI:0.738-0.937)and a sensitivity of 0.836(95％CI:0.717-0.911).The AUC of CD8+CD38+HLA-DR+T cells was 0.927(95％CI:0.872-0.982),with a specificity of 0.778(95％CI:0.662-0.891)and a sensitivity of 0.933(95％CI:0.821-0.977).Conclusion HLA-DR is involved in the key immune response of T cell activation in the peripheral blood of patients with sepsis,and has certain value in distinguishing different pathogenic bacterial infections in sepsis.
T cell activation spectrumSepsisPathogenic bacteriaHLA-DR
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