Clinical study on the types of pathogenic bacteria in sepsis patients based on T cell activation spectrum
Objective To explore the clinical value of T-cell activation spectrum in differentiating sepsis from different pathogenic bacteria.Method From September 2020 to June 2022,100 patients with sepsis who were treated in The First Af filiated Hospital of Xi'an Jiaotong University were selected as the sepsis group,and 37 healthy volunteers who underwent physical examination in outpatient department were selected as the control group.Sepsis group was divided into two groups according to the pathogenic results of patients admitted to hospital:Gram-negative group(n=46)and Gram-positive group(n=54).The expression of T lymphocytes and surface costimulatory molecules in peripheral blood was detected by flow cytometry.The ability of CD38+HLA-DR+T cells to distinguish Gram-negative sepsis from Gram-positive sepsis was evaluated by the subject operating curve(ROC).Result The proportions of CD4+CD38+CD69+T cells and CD8+CD38+CD69+T cells in peripheral blood of each sepsis subgroup were higher than those of the control group(all P＜0.05).There was no significant difference in the ratio of CD4+CD38+CD69+T cells and CD8+CD38+CD69+T cells between Gram-positive group and Gram-negative group(both 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 sepsis subgroup were significantly increased(P＜0.05),and the increase degree of Gram-negative group was greater than that of Gram-positive group(P＜0.05).When distinguishing Gram-negative sepsis from Gram-positive sepsis,the AUC of CD4+CD38+HLA-DR+T cells was 0.901(95％CI 0.837-0.965),the specificity was 0.867,and the sensitivity was 0.836;the AUC of CD8+CD38+HLA-DR+T cells was 0.927(95％CI 0.872-0.982),the specificity was 0.778 and the sensitivity was 0.933.Conclusion HLA-DR is involved in the key immune response of T cell activation in the peripheral blood of sepsis patients,which can distinguish the infection of different pathogenic bacteria in sepsis.
万方数据
维普
