The value of T cell subset monitoring for traumatic sepsis patients defined by sepsis-3
10.3760/cma.j.issn.1671-0282.2019.02.010
- VernacularTitle:T细胞亚群监测在基于Sepsis-3的创伤性脓毒症患者中的应用
- Author:
Caizhen HU
1
;
Ligang YE
;
Shanxiang XU
Author Information
1. 浙江大学医学院附属第二医院急诊科
- Keywords:
Trauma;
Sepsis;
T cell subse
- From:
Chinese Journal of Emergency Medicine
2019;28(2):181-184
- CountryChina
- Language:Chinese
-
Abstract:
Objective To estimate the value of T cell subset monitoring on early diagnosis and prognosis in traumatic sepsis patients defined by sepsis-3.Methods A total of 102 severe trauma patients were prospectively collected in an Emergency Intensive Care Unit (EICU) of a tertiary hospital from 1st July 2017 to 30th September 2017.Finally 28 patients were confirmed as sepsis according to the sepsis-3 guideline.The levels of blood T cell subsets (CD3,CD4,and CD8) were measured at day 1,3 and 7 after ICU admission and after diagnosis.Receiver operating characteristic curve and multivariate regression analysis were used.Results The levels of CD3 and CD4,and CD4/CD8 ratio in severe trauma patients first decreased and then increased within one week after admission,while CD8 level first increased and then decreased.The levels of CD3 and CD4 and CD4/CD8 ratio showed a decreased tendency and CD8 level showed an increased tendency in the death and traumatic sepsis groups.The CD4/CD8 ratio at day 1 after admission was relatively effective in diagnosing traumatic sepsis.The area under the ROC curve was 0.901 with a sensitivity and specificity of 88.89％ and 83.33％,respectively.The CD4/CD8 ratio at day 1 after diagnosis of traumatic sepsis was a risk factor for predicting patient mortality (OR=1.43;95％CI:1.27-1.89).Conclusions Cellular immunity in severe trauma patients presents a process of inhibition before recovery.The CD4/CD8 ratio can better diagnose traumatic sepsis and evaluate the prognosis..
