氧合指数联合T细胞亚群计数判断流感相关脓毒症患者预后的临床价值

doi:10.3969/j.issn.1002-1949.2019.05.011

Chinese Journal of Critical Care Medicine

2019, Vol. 39

Issue (5): 452-456 DOI: 10.3969/j.issn.1002-1949.2019.05.011

Clinical value of oxygenation index combined with T cell subsets count in predicting prognosis of patients with influenza-associated sepsis

Teng Fei, Mei Xue, Guo Shu-Bin

Department of Emergency, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China

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Abstract Objective Patients with influenza-associated sepsis are mainly involved in respiratory system and immune system damage in the early stage of development. This study aimed to determine the prognosis of patients with influenza-associated sepsis by oxygenation index and absolute count of T cell subsets, as well as other effective clinical indicators. Methods A retrospective study was conducted on influenza-associated sepsis patients admitted from the emergency department or fever clinic of Beijing Chao-Yang Hospital, Capital Medical University from 2013 to 2018. The patients were divided into a survival group and a death group, with the 28-day mortality as the end point of the study. The differences in clinical characteristics between the two groups were compared and analyzed. The predictive power of the model was evaluated by the area under the receiver operating characteristic (ROC) curve (AUC). Results A total of 129 patients were included in the study, including 101(78%) in the 28-day survival group and 28(22%) in the 28-day death group. Age in the death group was higher than that in the survival group ［64(51, 72) vs. 57(44, 66), P=0.086］. Glasgow coma scale (GCS) in the death group was lower than that in the survival group (9.5±5.0 vs. 12.2±4.1, P=0.012). CD4+T cell count in the death group was lower than that in the survival group ［(297±235）×106/L vs. （453±355）×106/L, P=0.008］. CD8+ T cell count in the death group was lower than that in the survival group ［(156±112）×106/L vs. （259±181）×106/L, P=0.001］. Oxygenation index in the death group was lower than that in the survival group［(187.5±49.7）vs.（255.6±99.9）, P<0.001］. Multivariate Logistic regression analysis showed that age, GCS score, oxygenation index and CD8+ T cell count were independent indicators for predicting the mortality of patients with influenza-associated sepsis, with OR values of 1.041 (95%CI 1.006-1.078), 0.902 (95%CI0.813-1.000), 0.986 (95%CI0.978-0.995), and 0.995 (95%CI0.991-1.000), respectively. The AUC of the combined predictive value of 0.820 (95%CI0.739-0.901) was higher than that of the SOFA score of 0.726 (95%CI0.617-0.835，Z=1.681, P=0.09). Conclusion The combination of age, GCS score, oxygenation index, and CD8+ T cell count predicts the risk of mortality in patients with influenza-associated sepsis.

Key words： Influenza Sepsis Oxygenation index T cell subsets Emergency

Corresponding Authors: Guo Shu-Bin, E-mail: shubinguo@126.com

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Teng Fei,Mei Xue,Guo Shu-Bin. Clinical value of oxygenation index combined with T cell subsets count in predicting prognosis of patients with influenza-associated sepsis[J]. Chinese Journal of Critical Care Medicine, 2019, 39(5): 452-456.

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http://www.cnemergency.org.cn/EN/10.3969/j.issn.1002-1949.2019.05.011 OR http://www.cnemergency.org.cn/EN/Y2019/V39/I5/452

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