【摘要】 目的探讨淋巴细胞亚群对脓毒症患者死亡风险的预测价值。方法选取2012年3月—2013年12月宁夏人民医院急诊重症监护室及重症监护室收治的脓毒症患者101例为研究对象,按预后将患者分为存活组(80例)和死亡组(21例)。入院48 h内检测淋巴细胞亚群水平,应用主成分分析提取综合预测因子,评估淋巴细胞亚群对脓毒症患者死亡风险的预测价值。结果不同类型的脓毒症患者总T淋巴细胞、总B淋巴细胞、辅助/调节T淋巴细胞(Th)、抑制/细胞毒T淋巴细胞(Ts)、Th/Ts和总NK细胞表达水平比较,差异均有统计学意义(P<0.05)。严重脓毒症患者中,死亡组Ts表达水平低于生存组(P<0.05);脓毒性休克患者中,死亡组Th表达水平低于生存组(P<0.05)。淋巴细胞亚群综合预测因子预测脓毒症患者死亡风险的受试者工作特征曲线下面积为0.983〔95%CI(0.934,0.998)〕。结论脓毒症患者淋巴细胞亚群表达异常,淋巴细胞亚群综合预测因子对脓毒症患者的死亡风险有较高的预测价值。更多还原

【Abstract】 Objective To observe the predictive value of lymphocyte subsets for mortality risk in sepsis patients.Methods From March 2012 to December 2013,101 sepsis patients were enrolled in this study and divided in EICU and ICU of the Ningxia People’s Hospital, according to prognosis, into groups survival( n = 80), death( n = 21). The level of lymphocyte subsets were detected at 48 hours after admission,and comprehensive predictor was extracted by principal component analysis. The predictive values of lymphocyte subsets for mortality risk of sepsis patients were evaluated. Results There was significant difference in total T lymphocytes,total B lymphocytes,helper / regulatory T lymphocytes( Th),suppressor / cytotoxic T lymphocytes( Ts),Th / Ts,total NK cells between different types of sepsis patients( P < 0. 05). In severe sepsis patients,suppressor / cytotoxic T lymphocytes were lower in death group than in survival group( P < 0. 05); in septic shock patients,auxiliary / regulatory T lymphocytes were lower in death group than in survival group( P < 0. 05). The area under the receiver-operating curve of lymphocyte subsets comprehensive predictor predicting sepsis patients’ death risks was 0. 983 〔95% CI( 0. 934,0. 998) 〕. Conclusion Lymphocyte subsets express abnormally in sepsis patients. The comprehensive predictor of lymphocyte subsets is of high predictive values in predicting sepsis patients’ death risks.更多还原