Influence of metabolism syndrome on T lymphocyte subsets and prognosis in patients with septic shock

He Shudian; Xing Bo

doi:10.3760/cma.j.issn.1673-4777.2017.12.018

Abstract：Objective To investigate the influence of metabolism syndrome(MS) on T lymphocyte subsets and prognosis in patients with septic shock.Methods A total of 93 patients with septic shock admitted in Department of Emergency of Donghu Branch of the Second Affiliated Hospital of Hainan Medical University from January 2014 to June 2017 were divided into non-MS group(48 cases) and MS group(45 cases).All patients had routine positive treatments for septic shock after admission.T lymphocyte subsets and clinical end-point indicators were recorded.Effect of MS on T lymphocyte subsets and prognosis in patients with septic shock was analyzed by Pearson test.Results Score of the Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) in MS group was significantly higher than that in non-MS group[(23 ± 5) points vs (21 ± 6) points] (P ＜ 0.05).Levels of CD3+ 、CD4+ and CD8+ in MS group were significantly lower than those in non-MS group[(50 ±6)％ vs (55 ± 7)％,(36 ±6)％ vs (39 ±6)％,(18 ±5)％ vs (21 ±6)％] (P ＜0.05).The CD4+/CD8+ ratio had no significant difference between groups(P ＞ 0.05).Mechanical ventilation time,vasoactive agent use time and continuous renal replacement therapy time in MS group were significantly longer than those in non-MS group;the 28 d fatality rate in MS group was significantly higher that in non-MS group [(4.4 ± 3.6) d vs (2.9 ± 2.8) d,(6.9 ± 2.1) d vs (5.9 ± 1.7)d,(4.1 ±3.0)d vs (2.8 ±2.7)d,37.8％ (17/45) vs 16.7％ (8/48)] (P ＜0.05).Intensive Care Unit stay time had no significant difference between groups (P ＞ 0.05).Pearson correlation analysis showed that the APACHE Ⅱ score was negatively correlated with the level of CD4+ T lymphocyte (r =-0.256,P =0.013).Conclusion MS may aggravate abnormal expression of T lymphocyte subsets and severity of septic shock;CD4+ T lymphocyte is closely related to the severity of septic shock.