淋巴细胞亚群联合检测对脓毒症患者不良预后的评估价值.docVIP

　　淋巴细胞亚群联合检测对脓毒症患者不良预后的评估价值 【摘要】目的探讨T、B和NK淋巴细胞亚群相关指标对脓毒症患者不良预后的预测价值。 方法应用前瞻性研究方法，选取宁夏人民医院急诊重症监护室（EICU）及ICU共101例脓毒症患者为对象，检测入院48 h内外周血T、B和NK淋巴细胞亚群相关指标水平，随访至出院，观察指标异常对死亡结局的危险度，评估各指标联合检测对死亡风险的预测价值。结果脓毒性休克患者CD3、CD3+/CD4+低于脓毒症组和严重脓毒症组，严重脓毒症和脓毒性休克患者CD3+/CD8+，CD3-/CD19+，CD4+/CD8+低于脓毒症组，CD（16+56）+高于脓毒症组（Plt;0.05）;死亡患者的单核细胞高于生存患者，CD3、CD3-/CD19+、CD3+/CD4+、CD4+/CD8+低于生存患者（Plt;0.05）;CD3-/CD19+、CD3+/CD8、CD4+/CD8+为脓毒症预后的保护因素，OR值分别0.235、0.006、0.108;淋巴细胞亚群联合预测因子、APACHE Ⅱ评分、SOFA评分对死亡风险预测效能的ROC曲线下面积分别为0.993、0.877、0.848;淋巴细胞亚群联合判别函数对病情程度的误判率为19.8%，对患者结局的误判率为4%。结论脓毒症患者淋巴细胞亚群表达异常，淋巴细胞亚群的联合检测对脓毒症患者的病情及预后有指导价值。　　【关键词】脓毒症;淋巴细胞亚群;预后;前瞻性研究　　Value of lymphocyte subgroups jointly detected in assessing poor prognosis of patients ily: 宋体; line-height: 18px; /　　Pan Dongfeng，Li Furong，Liang Shisong，Qi Kele，Ji Xinzhong，Ke Jinfang. Emergency Department，Ningxia Peoples Hosptial，Yinchuan 750021，China　　Corresponding author：Pan Dongfeng，Email：[email#160;protected]　　【Abstract】ObjectiveTo investigate the predictive value of T， B， and NK lymphocyte subsets jointly detected in poor prognosis in patients phocyte sub-populations in peripheral blood ission. The outes of patients during hospitalization phocyte sub-populations jointly detected in death risk ild/moderate sepsis and severe sepsis. The percentages of CD3+/CD8+， CD3-/CD19+， CD4+/CD8 + in patients ild/moderate sepsis. The percentage of CD （16+56）+ in severe sepsis and septic shock ild/moderate sepsis group （Plt;0.05）. The total number of monocytes in the deaths phocyte subsets jointly detected， APACHE Ⅱ score and SOFA score to predict the risk of death isjudgment rate of discriminating disease severity function of lymphocyte subgroups jointly detected phocyte sub-populations in patients al， and therefore， the lymphocyte subgroups jointly detected has value in the judgment of disease severity and prognosis in patients phocyte subsets;Prognosis;Perspective study　　脓毒症为感染或创伤等引起的全身性炎症反应综合征，其发生率高，病情凶险，病死率高lt;supgt;[1]lt;/supgt;。据国外流行病学调查显示，脓毒症的病死率已经超过心肌梗死，成