Sun Yingqian, Lu Yan, Xing Rui, Zhang Yongjun, Zhang Longyi
Clinical Laboratory, Affiliated Dongyang Hospital of Wenzhou Medical University, Zhejiang, China.
The Department of Hematology, Affiliated Dongyang Hospital of Wenzhou Medical University, Zhejiang, China.
Front Med (Lausanne). 2024 May 10;11:1328719. doi: 10.3389/fmed.2024.1328719. eCollection 2024.
To date, the correlation between CD4 on the monocytes (mCD4) expression and the prognosis of patients with septic shock remains unclear. The purpose of this study was to analyze the expression of mCD4 in these patients and further evaluate whether mCD4 expression correlates with either the recovery from multiple organ dysfunction syndrome (MODS) or mortality.
The study participants were recruited from a tertiary general hospital in China (Affiliated Dongyang Hospital of Wenzhou Medical University). Sepsis and septic shock were diagnosed based on the diagnostic criteria of Sepsis-3. MODS was defined as a Sequential Organ Failure Assessment score of at least two organ systems ≥2. Persistent MODS was defined as the continual meeting of the MODS criteria when re-evaluated one week after admission (day 7). A logistic regression model was used to test whether mCD4 was an independent prognostic factor for mortality in patients with septic shock. A paired sample rank sum test was used to examine the correlation between mCD4 expression and MODS recovery.
The study recruited 79 patients with septic shock as the study group, 74 patients with sepsis as the disease control group, and 56 volunteers as healthy controls. In the first 24 h after admission (day 1), mCD4 expression was significantly reduced in patients with septic shock compared to healthy controls and patients with sepsis. Moreover, mCD4 expression was an independent prognostic factor for in-hospital and 28 day mortality in patients with septic shock. mCD4 expression did not show significant differences in patients with persistent MODS on day 7 compared to day 1. However, mCD4 expression was significantly higher in patients without persistent MODS on day 7 than on day 1.
mCD4 expression is significantly reduced in patients with septic shock, which is an independent prognostic factor for mortality and closely related to recovery from MODS.
迄今为止，单核细胞上CD4（mCD4）的表达与脓毒性休克患者预后之间的相关性仍不明确。本研究旨在分析这些患者中mCD4的表达情况，并进一步评估mCD4表达是否与多器官功能障碍综合征（MODS）的恢复或死亡率相关。
研究参与者来自中国一家三级综合医院（温州医科大学附属东阳医院）。根据Sepsis-3的诊断标准诊断脓毒症和脓毒性休克。MODS定义为序贯器官衰竭评估中至少两个器官系统评分≥2。持续性MODS定义为入院一周（第7天）后重新评估时持续符合MODS标准。采用逻辑回归模型检验mCD4是否为脓毒性休克患者死亡率的独立预后因素。采用配对样本秩和检验来检验mCD4表达与MODS恢复之间的相关性。
本研究招募了79例脓毒性休克患者作为研究组，74例脓毒症患者作为疾病对照组，56名志愿者作为健康对照组。入院后最初24小时（第1天），与健康对照组和脓毒症患者相比，脓毒性休克患者的mCD4表达显著降低。此外，mCD4表达是脓毒性休克患者院内和28天死亡率的独立预后因素。第7天持续性MODS患者的mCD4表达与第1天相比无显著差异。然而，第7天无持续性MODS患者的mCD4表达显著高于第1天。
脓毒性休克患者的mCD4表达显著降低，这是死亡率的独立预后因素，且与MODS的恢复密切相关。
