Th17 细胞比例与疾病严重程度升高、炎症水平升高和脓毒症患者预后不良密切相关，而非 Th1 细胞比例。
Th17, rather than Th1 cell proportion, is closely correlated with elevated disease severity, higher inflammation level, and worse prognosis in sepsis patients.
机构信息
Department of Intensive Care Unit, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
出版信息
J Clin Lab Anal. 2021 May;35(5):e23753. doi: 10.1002/jcla.23753. Epub 2021 Mar 11.
OBJECTIVE
The current study aimed to investigate the prognostic value of T helper (Th) 1 and Th17 proportions in sepsis patients.
METHODS
Th1 and Th17 cells in blood CD4 T cells were detected by flow cytometry in 210 sepsis patients and 100 healthy controls (HCs). Besides, serum interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), and interleukin-17 (IL-17) levels in the enrolled sepsis patients were determined with enzyme-linked immunosorbent assay.
RESULTS
Compared with HCs, Th1 and Th17 proportions were elevated in sepsis patients (both p < .001). Meanwhile, Th1 proportion was strongly correlated with IFN-γ (p < .001, r = .484) but weakly correlated with TNF-α (p = .024, r = .156) and IL-17 (p = .002, r = .212), while Th17 proportion showed faint correlation with IFN-γ (p = .015, r = .168), but strong correlations with TNF-α (p < .001, r = .602) and IL-17 (p < .001, r = .498) in sepsis patients. Besides, Th1 proportion was weakly associated with APACHE II score (p = .030, r = .150), but Th17 proportion was closely associated with APACHE II score (p < .001, r = .322) and SOFA score (p < .001, r = .337) in sepsis patients. Regarding their prognostic value, Th1 proportion (p = .042) was slightly, while Th17 proportion (p < .001) was dramatically, increased in septic deaths compared with survivors, and Th17 possessed good predictive value for 28-day mortality risk (AUC: 0.748, 95% CI: 0.659-0.836).
CONCLUSION
Th1 and Th17 proportions are elevated in sepsis patients compared with HCs, and Th17 proportion is correlated with increased disease severity, higher inflammation level, and worse prognosis in sepsis patients.
目的
本研究旨在探讨辅助性 T 细胞（Th）1 和 Th17 比例在脓毒症患者中的预后价值。
方法
采用流式细胞术检测 210 例脓毒症患者和 100 例健康对照者（HCs）的血液 CD4 T 细胞中的 Th1 和 Th17 细胞，并采用酶联免疫吸附试验测定入组脓毒症患者的血清干扰素-γ（IFN-γ）、肿瘤坏死因子-α（TNF-α）和白细胞介素-17（IL-17）水平。
结果
与 HCs 相比，脓毒症患者的 Th1 和 Th17 比例升高（均 P<0.001）。同时，Th1 比例与 IFN-γ呈强相关（P<0.001，r=0.484），与 TNF-α和 IL-17 呈弱相关（P=0.024，r=0.156；P=0.002，r=0.212），而 Th17 比例与 IFN-γ呈弱相关（P=0.015，r=0.168），与 TNF-α和 IL-17 呈强相关（P<0.001，r=0.602；P<0.001，r=0.498）。此外，Th1 比例与急性生理与慢性健康评分Ⅱ（APACHEⅡ）评分呈弱相关（P=0.030，r=0.150），而 Th17 比例与 APACHEⅡ评分（P<0.001，r=0.322）和序贯器官衰竭评估（SOFA）评分（P<0.001，r=0.337）密切相关。关于其预后价值，与存活者相比，Th1 比例（P=0.042）略有升高，而 Th17 比例（P<0.001）显著升高，Th17 对 28 天死亡率风险具有良好的预测价值（AUC：0.748，95%CI：0.659-0.836）。
结论
与 HCs 相比，脓毒症患者的 Th1 和 Th17 比例升高，Th17 比例与疾病严重程度增加、炎症水平升高和预后不良相关。
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