S-ChE联合T细胞表面PD-1水平对脓毒症患者病情预后状况评估的价值

doi:10.3969/j.issn.1000-8535.2023.02.017

摘要/Abstract

摘要： 目的观察脓毒症患者血清胆碱酯酶(S-ChE)和T细胞程序性死亡分子-1(PD-1)以及炎症因子水平,并分析其与患者预后关系。方法选取2018年8月—2021年5月在我院接受治疗的脓毒症患者为研究对象,同时选取同期在我院接受体检的健康人群为对照组。根据脓毒症患者的预后分为存活组和死亡组。比较脓毒症组和对照组、脓毒症存活组和死亡组患者S-ChE、PD-1水平和炎症因子水平的差异,并分析与患者预后的关系。结果脓毒症患者的S-ChE水平低于对照组,PD-1水平高于对照组(P＜0.05)。脓毒症患者的CRP、PCT水平高于对照组,CD3⁺T、CD3⁺CD4⁺T和CD4⁺CD8⁺T水平低于对照组(P＜0.05)。死亡组患者的S-ChE水平低于存活组,PD-1水平高于存活组(P＜0.05)。死亡组患者的CRP、PCT水平高于存活组,CD3⁺T、CD3⁺CD4⁺T和CD4⁺CD8⁺T水平低于存活组(P＜0.05)。脓毒症患者S-ChE、PD-1水平呈负相关,(P＜0.05)。脓毒症患者的S-ChE与 CRP、PCT水平负相关,与CD3⁺T、CD3⁺CD4⁺T、CD4⁺CD8⁺T水平正相关(P＜0.05)。脓毒症患者的PD-1与 CRP、PCT水平正相关,与CD3⁺T、CD3⁺CD4⁺T、CD4⁺CD8⁺T水平负相关(P＜0.05)。S-ChE、PD-1预测脓毒症患者预后的AUC值为0.725(95%CI:0.605~0.825)、0.706(95%CI:0.585~0.809),P＜0.05。结论脓毒症患者的S-ChE水平较低,PD-1水平较高,且与炎症因子水平和患者的预后相关。

关键词: 脓毒症, 胆碱酯酶, T细胞程序性死亡分子-1, 预后

Abstract: Objective To analyze the levels of serum cholinesterase (S-ChE), programmed death 1 (PD-1) and inflammatory factors in patients with sepsis, and analyze the relationship between them and the prognosis of patients. Methods Patients with sepsis treated in our hospital from August 2018 to May 2021 were selected as the research subjects, and healthy people who received physical examinations in our hospital during the same period were selected as the control subjects.The differences in the levels of S-ChE, PD-1 and inflammatory factors between the sepsis group and the control group, the sepsis survival group and the death group were compared, and their relationship with the prognosis of the patients were analyzed. Results The level of S-ChE in patients with sepsis was lower than that of the control group, and the level of PD-1 was higher than that of the control group (P<0.05).The CRP and PCT levels of sepsis patients were higher than those of the control subjects, and the levels of CD3⁺T, CD3⁺CD4⁺T and CD4⁺CD8⁺T were lower (P<0.05).The S-ChE level of the death group was lower than that of the survival group, and the PD-1 level was higher than that of the survival group (P<0.05).The levels of CRP and PCT in the death group were higher than those in the survival group, and the levels of CD3⁺T, CD3⁺CD4⁺T and CD4⁺CD8⁺T were lower than those in the survival group (P<0.05).The levels of S-ChE and PD-1 in sepsis patients were negatively correlated (P< 0.05).S-ChE level in patients with sepsis was negatively correlated with CRP and PCT levels, and positively correlated with CD3⁺T, CD3⁺CD4⁺T, and CD4⁺CD8⁺T levels (P<0.05).PD-1 level in patients with sepsis was positively correlated with CRP and PCT levels, and negatively correlated with CD3⁺T, CD3⁺CD4⁺T, and CD4⁺CD8⁺T levels (P<0.05).The AUC values of S-ChE and PD-1 predicting the prognosis of patients with sepsis were 0.725 (95% CI: 0.605~0.825), 0.706 (95% CI: 0.585~0.809), P＜0.05. Conclusions Patients with sepsis had lower level of S-ChE and higher level of PD-1, which were related to the levels of inflammatory factors and the prognosis of patients.

Key words: sepsis, cholinesterase, T cell programmed death molecule-1, prognosis

唐苏予, 陈光辉, 王真珍. S-ChE联合T细胞表面PD-1水平对脓毒症患者病情预后状况评估的价值[J]. 广州医药, 2023, 54(2): 83-87.

TANG Suyu, CHEN Guanghui, WANG Zhenzhen. The effect of S-ChE combined with T cell surface PD-1 level on the evaluation of the prognosis of patients with sepsis[J]. Guangzhou Medical Journal, 2023, 54(2): 83-87.

参考文献

[1] 田兴国, 陈志, 贺慧为,等.多黏菌素B血液灌流对脓毒症和脓毒症休克患者预后影响的荟萃分析[J].中国呼吸与危重监护杂志, 2020,19(1):22-27.
[2] 吴相伟, 叶继辉, 孙敏, 等.CRRT启动时机与脓毒症相关性AKI患者预后的关系[J].中华危重病急救医学, 2020, 32(11):1352-1355.
[3] OCHOA T, MENDOZA K, CARCAMO C, et al.Is mother's own milk lactoferrin intake associated with reduced neonatal sepsis, necrotizing enterocolitis, and death?[J].Neonatology, 2020, 117(2):1-8.
[4] HAYASHI N, SAWADA Y, UJIMOTO K, et al.Diagnosis of sepsis by ai-aided proteomics using 2D electrophoresis images of patient serum incorporating transfer learning for deep neural networks[J].Applied Sciences, 2021, 11(4):1967.
[5] VANCE J K, RAWSON T W, POVROZNIK J M, et al.Myeloid-derived suppressor cells gain suppressive function during neonatal bacterial sepsis[J].Int J Mol Sci, 2021, 22(13):7047.
[6] AMUNDSEN E K, BINDE C, CHRISTENSEN E E, et al.Prognostic value of nucleated rbcs for patients with suspected sepsis in the emergency department: a single-center prospective cohort study[J].Crit Care Explor, 2021, 3(7):e0490.
[7] 宗恒,汤雷,张艳,等.血清胆碱酯酶在结肠癌肝转移患者中的疗效预测作用[J].肝胆外科杂志, 2020, 28(4):281-284.
[8] 简娟,驾志飚,刘继强,等.胆碱酯酶、乳酸对脓毒症患者病情严重程度及预后的评估价值[J].中华危重症医学杂志(电子版), 2020, 13(5):339-344.
[9] 邱春芳, 吴健锋, 裴飞,等.血浆氧化应激因子水平与脓毒症患者预后的相关性研究[J].中华危重病急救医学, 2019, 31(7):847-851.
[10] 李兴华, 刘颖, 吕艳超.脓毒血症患者乳酸清除率,红细胞分布宽度和血乳酸水平及与预后的关系[J].中国现代医学杂志, 2020, 30(12):22-26.
[11] 陈梅, 宋春兰, 成怡冰.外周血Treg,Th17,血乳酸,NLR值的变化与脓毒症患儿预后的关系[J].中华医院感染学杂志, 2020, 30(2):100-103.
[12] 杨静, 何浩, 谭波,等.血清高迁移率族蛋白B1,调节性T细胞(Treg)水平对脓毒症患者肠屏障状况及临床预后的影响[J].中华医院感染学杂志, 2020, 30(1):64-67.
[13] 邹琪, 赵士兵, 吴强,等.脓毒症患者外周血淋巴细胞中微小RNA-126表达量与细胞凋亡及预后的相关性分析[J].中华危重病急救医学, 2020, 32(8):938-942.
[14] 许秀娟, 孟建标, 方强.血中微量元素铜和锌水平对脓毒症患者预后的预测价值分析[J].中华危重病急救医学, 2020, 32(11):1320-1323.
[15] 孙珊, 宋爱琴.新型生物标志物在脓毒症诊断,治疗和预后中的潜在价值[J].中国现代医学杂志, 2020, 30(5):72-76.