Evaluation of T Lymphocyte Subsets in Sepsis Patients with Secondary Persistent Inflammation-Immunosuppression-Catabolism Syndrome
YU Zuqi, REN Shengyong
Department of Intensive Care Medicine, The First Affiliated Hospital of Zhengzhou University / Henan Provincial People's Hospital, Zhengzhou Henan 450000
Abstract：【Objective】To explore the application value of T lymphocyte subsets in patients with sepsis and secondary persistent inflammation-immunosuppression-catabolism syndrome(PICS).【Methods】 A total of 196 sepsis patients were included in the study. Based on whether patients had PICS, they were divided into the PICS group (n=67) and the non-PICS group (n=129). Arterial blood lactate level, immune function [T lymphocyte subset levels (CD3+, CD4+, CD4+/CD8+)], inflammation markers [C-reactive protein (CRP), interleukin-6 (IL-6), procalcitonin (PCT)], and nutritional indicators [serum total protein (TP), albumin (ALB), prealbumin (PA), hemoglobin (Hb)] were compared between the two groups. Multivariate analysis was used to identify the factors influencing the development of PICS in sepsis patients, and receiver operating characteristic (ROC) curves were used to evaluate the predictive value of T lymphocyte subsets in the occurrence of PICS.【Results】 The PICS group had lower blood lactate and inflammatory factor levels than the non-PICS group, while T lymphocyte subsets and nutritional indicators were higher in the PICS group (all P<0.05). Multivariate analysis showed that blood lactate, inflammatory levels, immune function, and nutritional status were important factors influencing the development of PICS in sepsis patients (P<0.05). The combined detection of T lymphocyte subsets showed an area under the curve (AUC) of 0.965 for predicting PICS in sepsis patients, which was higher than the individual tests of T lymphocyte subsets (P<0.05).【Conclusion】 T lymphocyte subset levels have high predictive value for the occurrence of PICS in sepsis patients.
[1] 李桂仙,潘兴邦,顾伟.可溶性白细胞介素7受体联合其他生物标志物对急诊脓毒症的诊断价值[J].中国医师杂志,2023,25(3):388-392. [2] 唐庭轩,唐良晟,陈登,等.严重多发伤患者并发持续炎症-免疫抑制-分解代谢综合征的早期警示因子[J].中华急诊医学杂志,2022,31(5):598-602. [3] TANG Y W, WU J X, TIAN Y,et al. Predictive value of peripheral lymphocyte subsets for the disease progression in patients with sepsis[J].Int Immunopharmacol,2023, 117(1):109-114. [4] 中国医师协会急诊医师分会,中国研究型医院学会休克与脓毒症专业委员会.中国脓毒症/脓毒性休克急诊治疗指南(2018)[J].中国急救医学,2018,38(9):741-756. [5] GENTILE L F, CUENCA A G, EFRON P A,et al. Persistent inflammation and immunosuppression: a common syndrome and new horizon for surgical intensive care[J].J Trauma Acute Care Surg,2012,72(6):1491-1501. [6] INOUE S, NAKANISHI N, SUGIYAMA J,et al. Prevalence and long-term prognosis of post-intensive care syndrome after sepsis: a single-center prospective observational study[J].J Clin Med,2022,11(18):525-527. [7] MANKOWSKI R T, ANTON S D, GHITA G L, et al. Older adults demonstrate biomarker evidence of the persistent inflammation, immunosuppression, and catabolism syndrome (PICS) after sepsis[J].J Gerontol A Biol Sci Med Sci,2022, 77(1):188-196. [8] URUSHIDANI S, KURIYAMA A, MATSUMURA M. Blood gas analysis results and serum lactate levels in patients with psychogenic hyperventilation and urinary tract infection with suspected sepsis: a retrospective comparative study[J].Intern Med,2022, 61(11):1699-1706. [9] PENG Y J, WU Q Y, DING X H, et al. A hypoxia- and lactate metabolism-related gene signature to predict prognosis of sepsis: discovery and validation in independent cohorts[J].Eur J Med Res,2023, 28(1):320-325. [10] SUMANTRI S, RENGGANIS I. Immunological dysfunction and mast cell activation syndrome in long COVID[J].Asia Pac Allergy,2023, 13(1):50-53. [11] VANKRUNKELSVEN W, DERDE S, GUNST J,et al. Obesity attenuates inflammation, protein catabolism, dyslipidaemia, and muscle weakness during sepsis, independent of leptin[J].J Cachexia Sarcopenia Muscle,2022, 13(1):418. [12] HUANG Q G, DING Y W, FANG C,et al. The emerging role of ferroptosis in sepsis, opportunity or challenge?[J].Infect Drug Resist,2023, 16(12):5551-5562. [13] SCHIRM S, SCHOLZ M. A biomathematical model of human erythropoiesis and iron metabolism[J].Sci Rep,2020, 10(1):86-92.
2025, Vol. 42 
