Dynamic observation on T lymphocyte subsets in patients with sepsis

Objective To observe the changes of T lymphocyte subsets in patients with sepsis,and discuss its relationship with condition and prognosis.Methods Sixty patients with sepsis and 40 patients with severe sepsis were included in this study.Thirty non-septic patients were selected as control group.Flow cytometer was used to detect the percentage of CD3+T,CD4+T and CD8+T,and CD4+T/CD8+T was calculated.These data and the APACHEⅡ score were recorded both in the first day and seventh day after admission.According to the outcome,patients with sepsis were divided into survival group and non-survival group,then the detection data were compared.Results In the first day of admission,compared with the patients with sepsis and non-septic patients,the patients with severe sepsis had a lower CD3+T,CD4+T and CD4+T/CD8+T(P0.05),and higher APACHEⅡscores(P0.05).There was no statistical difference between non-septic and septic patients in CD3+T,CD4+T,CD8+T,CD4+T/CD8+T and APACHEⅡscore(P0.05).In the seventh day of admission,non-survival patients with sepsis had a statistical decrease of CD3+T,CD4+T and CD4+T/CD8+T(P0.05),and statistical increase of APACHEⅡscore(P0.05);non-survival patients with severe sepsis had no statistical change of CD3+T,CD4+T and CD4+T/CD8+T(P0.05),and statistical increase of APACHEⅡscore(P0.05).The values showed a negative linear correlation between CD4+T and APACHEⅡscore.According to the multivariate logistic regression analysis,CD4+T,APACHEⅡ score and the number of dysfunction organ were independent risk factors for judging the prognosis in the patients with sepsis.Conclusion T lymphocyte subsets in septic patients are different at various stages of the disease.With the progress of sepsis,the continued low level of CD4+T indicates bad outcome.Dynamic detection of T lymphocyte subsets in the peripheral blood of septic patients is of great clinical significance in judging the severity of disease.