Clinical Value of Detecting CD4+T Cells,sCD40,and CD154 in Patients with Invasive Fungal Bloodstream Infections

LI Cunhui; TANG Wanxiang; LUO Chengli

doi:10.16458/j.cnki.1007-0893.2024.20.007

Abstract：Objective To investigate the clinical value of peripheral blood detecting cluster of differentiation(CD)4+T cells,soluble CD40(sCD40),and CD154 in patients with invasive fungal bloodstream infections.Methods A total of 131 patients with invasive fungal bloodstream infections admitted to the Second People's Hospital of Huangzhong District,Xining City from January 2021 to December 2023 were included in the infection group,and 73 healthy individuals undergoing physical examination during the same period were included in the control group.The proportion of CD4+T cells in lymphocytes,CD154 expression on CD4+T cell surfaces,and the level of sCD40 were measured.The patients in the infection group were divided into severe and mild groups to analyze the relationship between CD4+,sCD40,CD154 and disease severity.All patients were followed up for 28 days and divided into death and survival groups based on their survival status to analyze the predictive value of CD4+,sCD40,and CD154 on prognosis.Results The proportion of CD4+T cells in lymphocytes and CD154 expression on CD4+T cell surfaces in the infection group were higher than those in the control group,and the level of sCD40 was also higher than that in the control group.Moreover,these values were higher in the severe group than in the mild group and higher in the death group than in the survival group,with statistically significant differences(P<0.05).The area under the receiver operating characteristic(ROC)curve(AUC)for the combined detection of CD4+,sCD40,and CD154 to predict patient prognosis was 0.866,which was greater than the AUC for the individual detection of CD4+(0.771),sCD40(0.754),and CD154(0.705),with statistically significant differences(P<0.05).The cumulative survival rate of patients with CD4+≥51.17%was lower than that of patients with CD4+<51.17%,the cumulative survival rate of patients with sCD40≥509.66 pg·mL-1 was lower than that of patients with sCD40<509.66 pg·mL-1,and the cumulative survival rate of patients with CD154≥43.42%was lower than that of patients with CD154<43.42%,with statistically significant differences(P<0.05).Conclusion The levels of CD4+T cells,sCD40,and CD154 are significantly increased in patients with invasive fungal bloodstream infections,and the combined detection of these indicators has predictive value for patient prognosis.