Emergency and Critical Care Center, Department of Emergency Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China.
Graduate School of Clinical Medicine, Bengbu Medical College, Bengbu, China.
Front Public Health. 2022 Jul 14;10:928306. doi: 10.3389/fpubh.2022.928306. eCollection 2022.
Studies have shown that lymphocyte dysfunction can occur during the early stages of sepsis and that cell dysfunction is associated with mitochondrial dysfunction. Therefore, quantifying the mitochondrial function of lymphocytes in patients with sepsis could be valuable for the early diagnosis of sepsis.
Seventy-nine patients hospitalized from September 2020 to September 2021 with Sepsis-3 were retrospectively analyzed and subsequently compared with those without sepsis.
Univariate analysis showed statistical differences between the data of the two groups regarding age, neutrophil/lymphocyte, procalcitonin (PCT), C-reactive protein, total bilirubin, serum creatinine, type B natriuretic peptide, albumin, prothrombin time, activated partial thromboplastin time, lactic acid, single-cell mitochondrial mass (SCMM)-CD3, SCMM-CD4, SCMM-CD8, and Acute Physiology and Chronic Health Evaluation II score ( < 0.05). Multivariate logistic regression analysis performed on the indicators mentioned above demonstrated a statistical difference in PCT, lactic acid, SCMM-CD4, and SCMM-CD8 levels between the two groups ( < 0.05). The receiver operating characteristic curves of five models were subsequently compared [area under the curve: 0.740 (PCT) vs. 0.933 (SCMM-CD4) vs. 0.881 (SCMM-CD8) vs. 0.961 (PCT + SCMM-CD4) vs. 0.915 (PCT+SCMM-CD8), < 0.001].
SCMM-CD4 was shown to be a better diagnostic biomarker of early sepsis when compared with the traditional biomarker, PCT. Furthermore, the value of the combination of PCT and SCMM-CD4 in the diagnosis of early sepsis was better than that of SCMM-CD4 alone.
研究表明,淋巴细胞功能障碍可发生在脓毒症的早期阶段,而细胞功能障碍与线粒体功能障碍有关。因此,定量脓毒症患者淋巴细胞的线粒体功能可能对脓毒症的早期诊断有价值。
回顾性分析 2020 年 9 月至 2021 年 9 月因 Sepsis-3 住院的 79 例患者,并与非脓毒症患者进行比较。
单因素分析显示,两组患者的年龄、中性粒细胞/淋巴细胞、降钙素原(PCT)、C 反应蛋白、总胆红素、血肌酐、B 型利钠肽、白蛋白、凝血酶原时间、活化部分凝血活酶时间、乳酸、单细胞线粒体质量(SCMM)-CD3、SCMM-CD4、SCMM-CD8 和急性生理学和慢性健康评估 II 评分( < 0.05)有统计学差异。对上述指标进行多因素 logistic 回归分析,结果显示两组患者 PCT、乳酸、SCMM-CD4 和 SCMM-CD8 水平有统计学差异( < 0.05)。随后比较了五个模型的受试者工作特征曲线[曲线下面积:0.740(PCT)vs. 0.933(SCMM-CD4)vs. 0.881(SCMM-CD8)vs. 0.961(PCT+SCMM-CD4)vs. 0.915(PCT+SCMM-CD8), < 0.001]。
与传统标志物 PCT 相比,SCMM-CD4 是早期脓毒症更好的诊断生物标志物。此外,PCT 和 SCMM-CD4 联合在早期脓毒症诊断中的价值优于单独使用 SCMM-CD4。