Relationship of plasma CD40L levels to the severity of sepsis and prognosis

Wang Miao; Cao Shu-hua; Wang Bing; Yu Mei-xia; Yang Jun; Wang Yong-qiang

doi:10.3969/j.issn.1002-1949.2017.10.005

Abstract：Objective To determine whether plasma soluble CD40L level correlates to the degrees of sepsis,and its potential to be a marker of adverse outcome for sepsis patients. Methods This was a single center, prospective study carried out in ICU of the First Central Hospital of Tianjin. Plasma levels of sCD40L, APACHEⅡ, SOFA score and some other physiological and clinical laboratory test index were measured in 84 patients with sepsis at the time of diagnosis,who are divided into two groups are without thrombocytopenia group and thrombocytopenia group,and put the thrombocytopenia group into mild thrombocytopenia group, moderate thrombocytopenia group and severe thrombocytopenia group. Survival at 28 days was used as the endpoint. To compare the association with sCD40L and APACHEⅡ, SOFA score in different groups,and to observe sCD40L prediction of adverse consequences. Results①Plasma soluble CD40L levels were higher in without thrombocytopenia group than other groups( P<0. 001),there was significant difference in the levels of sCD40L among mild thrombocytopenia group, moderate thrombocytopenia group and severe thrombocytopenia group(P<0. 001).②No found sCD40L of without thrombocytopenia group was related to PLT counts(P > 0. 05),but it was relation with APACHEⅡ and SOFA score(r1 =0. 869,P <0. 001,r2 =0. 437,P =0. 018). sCD40L levels of thrombocytopenia groups were association with PLT counts(r=0. 936,P<0. 001),but no association with APACHEⅡ and SOFA score(P >0. 05);③Receiver operator characteristic curve(ROC)of the levels of sCD40L of without thrombocytopenia group was 0. 799,95%CI 0. 625~0. 973,P=0. 019. The best cut-off value of plasma sCD40L was 229. 411 pg/mL. Conclusion Thereis a relationship between plasma sCD40L level and the degree of sepsis for the patients without thrombocytopenia. Furthermore, plasma sCD40L level could be a marker of adverse outcome in patients of sepsis without thrombocytopenia.