Clinical Significance Of T Lymphocyte Subsets And Regulatory T Cell Detection In Patients With ICU Sepsis

Objective:In recent years,it has been found that immune disorders play an important role in the development of sepsis.Existing studies have confirmed that the development of sepsis is often accompanied by changes in T-lymphocyte subsets,which is associated with prognosis.With the deepening of the research on the pathogenesis of sepsis,the role of regulatory T lymphocytes in the development of sepsis is increasingly valued.However,most of the studies focused on animal experiments.Clinical studies on regulatory T lymphocytes have not been extensive.At the same time,there are few reports on T lymphocyte subsets and regulatory T lymphocytes.Therefore,the purpose of this study is to explore the changes of T lymphocyte subsets and regulatory T lymphocyte levels in the process of disease,and further clarify the immune mechanism of sepsis,so as to open up new clinical pathways for evaluating the severity and prognosis of sepsis.Methods:65 patients with sepsis in ICU from May 2017 to November 2017 were selected and divided into sepsis and septic shock groups according to the Sepsis1.0.25 patients in the same period were selected as the control group.The changes of T lymphocyte subsets and CD4~+CD25~+CD127~dimim T regulatory cell levels,PCT and Lac values in the peripheral blood among the three groups were detected by flow cytometry.The relationship between T lymphocyte subsets,regulatory T cell levels,and APACHE II scores and SOFA scores was explored.Results:1.The percentage of CD3~+T cells and the percentage of CD4~+T cells in the septic and septic shock groups were significantly lower than those in the control group(P<0.05).With the aggravation of the disease,the percentage of CD4~+T cells and the ratio of Th/Ts decreased more obviously(P<0.05).2.The percentage of Treg cells was higher than that in the control group,and the increase in septic shock group was more obvious than that of the sepsis group(P<0.05).There was no significant difference in the percentage of CD8~+T cells between the three groups(P>0.05).3.There was no significant difference between the survival group and the death group in terms of the percentage of CD4~+T cells,the percentage of Treg cells,the PCT and APACHEII scores(P>0.05).However,the SOFA score and the value of blood lactic acid in the survival group were significantly higher than those in the death group(P<0.05).4.There was no significant correlation between CD4~+T cells and APACHEII score,CD4~+T cells had a negative correlation with SOFA score(r=-0.316),Treg cells had no significant correlation with APACHEII score and SOFA score.Conclusion:1.In the peripheral blood of patients with sepsis,changes in the cellular levels of multiple T lymphocyte subsets were observed.2.Peripheral blood T-lymphocyte subsets and regulatory T-cell detection are of great value in judging the severity and prognosis of patients with ICU sepsis.