早期T细胞子组的变化及其对败血症患者预后的影响:单中心回顾性研究
Yanhua Li1, Youquan Wang1, Bin Chen2
1Department of Critical Care Medicine, The First Hospital of Jilin University, Changchun, China.
International journal of clinical practice
|January 3, 2024
概括
早期败血症通常涉及CD3+,CD4+和CD8+T细胞数量的减少,影响预后. 较低的CD4+/CD8+比率与败血症患者的长期存活率降低有关.
科学领域:
- 免疫学 免疫学 免疫学
- 关键护理医学 关键护理医学
- 临床病理学 临床病理学
背景情况:
- 败血症是一种危及生命的器官功能障碍,是由宿主对感染反应失调引起的.
- 免疫细胞子集的变化,特别是T细胞,与败血症的发病和结果有关.
- 了解早期的免疫变化可以指导治疗干预.
研究的目的:
- 在败血症患者中研究CD3+,CD4+和CD8+T细胞子集的早期变化.
- 为了将这些T细胞子集变化与患者的预后和存活率相关联.
- 建立临床免疫调节策略在败血症管理的基础.
主要方法:
- 一项对206名成人败血症患者 (SEPSIS 3.0标准) 进行的回顾性研究,这些患者被录入ICU.
- 细胞免疫检测 (CD3+,CD4+,CD8+T淋巴细胞计数,CD4+/CD8+比率) 在ICU入院后24小时内进行.
- 收集临床数据,包括人口统计,严重性评分 (APACHE II,SOFA),ICU停留,机械呼吸,死亡率和3年生存率.
主要成果:
- 在大多数败血症患者中,观察到CD3+ (76.7%),CD4+ (76.7%) 和CD8+ (63.6%) T细胞计数显著下降.
- 患有CD3+T细胞减少的患者在ICU停留时间较长,机械通风使用增加 (P<0.05).
- 降低CD4+/CD8+比率与较低的3年生存率相关 (P=0.01),尽管28天死亡率没有达到统计学意义.
结论:
- 早期败血症的特征是CD3+,CD4+和CD8+T细胞子集的减少以及CD4+/CD8+比率.
- 降低CD3+T细胞与较差的短期结果相关,例如延长ICU停留和通风.
- 降低CD4+/CD8+比率是败血症幸存者长期预后不佳的重要指标.
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