血清白细胞介素-35、T细胞亚群与脓毒症病情严重程度及预后的关系

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Abstract Objective To explore the relationship between serum interleukin-35 (IL-35), T cell subset and the severity and prognosis of patients with sepsis. Methods A total of 240 patients with sepsis admitted to Huainan First People’s Hospital, Anhui Province (hereinafter referred to as “our hospital”) from July 2019 to July 2020 were selected as the case group. According to their severity, they were divided into sepsis group (71 cases), severe sepsis group (126 cases) and septic shock group (43 cases). According to their prognosis 28 days after admission, they were divided into survival group (182 cases) and death group (58 cases). Sixty healthy subjects from our hospital during the same period were selected as control group. Serum IL-35 was detected by enzyme linked immunosorbent assay and T cell subsets were detected by flow cytometry. Acute physiology and chronic health evaluation (APACHEⅡ) scores of sepsis patients with different severity were compared. Sepsis-related organ failure assessment (SOFA) scores were compared between the survival group and the death group. The correlation of serum IL-35 and T cell subsets with APACHEⅡ and SOFA scores in the case group was analyzed. The predictive value of IL-35 and CD4+/CD8+ on the prognosis of sepsis was evaluated by the receiver operating characteristic curve. Results The levels of IL-35 and CD8+ in the case group were higher than those in the control group, and the levels of CD3+, CD4+, and CD4+/CD8+ in the case group were lower than those in the control group, with statistical significance (P ＜ 0.05). The levels of IL-35, CD8+, and APACHEⅡ scores in the severe sepsis group and septic shock group were higher than those in the sepsis group, and those in the septic shock group was higher than the severe sepsis group, the differences were statistically significant (P ＜ 0.05). The levels of CD3+, CD4+, and CD4+/CD8+ in severe sepsis group and septic shock group were lower than those in severe sepsis group, and the levels of septic shock group were lower than those in severe sepsis group, with statistical significance (P ＜ 0.05). The levels of IL-35, CD8+, and SOFA scores in the survival group were lower than those in the death group, and the levels of CD3+, CD4+ and, CD4+/CD8+ were higher than those in the death group, with statistical significance (P ＜ 0.05). IL-35 and CD8+ in the case group were positively correlated with APACHEⅡ and SOFA scores (r ＞ 0, P ＜ 0.05), while CD3+, CD4+, and CD4+/CD8+ were negatively correlated with APACHEⅡ and SOFA scores (r ＜ 0, P ＜ 0.05). The area under the curve of IL-35 combined with CD4+/CD8+ in predicting the death of sepsis patients after 28 days of treatment was 0.923, and the sensitivity and specificity were 91.38% and 95.05%, respectively. Conclusion Abnormal changes of serum IL-35 and T cell subsets are closely related to the severity and prognosis of patients with sepsis. Early combined detection can be used as an important indicator for clinical auxiliary prediction of prognosis.

Key words： Sepsis Interleukin-35 T cell subset Severity Prognosis

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	JIN Lei1
	2 ZHU Jiajia3 YANG Yadong1

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JIN Lei1,2 ZHU Jiajia3 YANG Yadong1. Relationship between serum interleukin-35, T cell subset and the severity and prognosis of patients with sepsis[J]. 中国医药导报, 2021, 18(25): 84-88.

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https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2021/V18/I25/84

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