体液和细胞免疫检测对脓毒症的诊断评估价值

目的观察细胞免疫和体液免疫检测指标对脓毒症患者的诊断和预后评估价值。方法采用回顾性研究,选取144例脓毒症入院患者,根据脓毒症严重程度和不同预后分组,收集患者体液免疫和细胞免疫检查结果,比较体液免疫和细胞免疫各个指标对脓毒症的临床诊断评估价值。对于非正态分布的计量资料进行对数转换。结果严重脓毒症组患者C3、C4、α2球蛋白水平均明显低于脓毒症组患者(1.91±0.22)mg/dlvs.(2.02±1.02)mg/dl;(1.25±0.27)mg/dlvs.(1.40±0.31)mg/dl;(11.75±3.66)mg/dlvs.(14.06±3.07)mg/dl,P均<0.05]。严重脓毒症β2微球蛋白水平高于脓毒症患者(0.86±0.70vs.0.34±0.15,P<0.05)。死亡组C3水平明显低于生存组患者(1.90±0.19)mg/dlvs.(1.98±0.18)mg/dl,P<0.05];β2微球蛋白水平高于生存组患者(-0.18±0.38vs.-0.40±0.28,P<0.05)。Logistic回归分析显示β2微球蛋白是脓毒症死亡的独立危险因子。然而,对于细胞免疫的各个指标,以不同严重程度和不同预后的脓毒症患者分组,结果均未发现有统计学意义。结论 C3、C4、α2球蛋白和β2微球蛋白有可能提示脓毒症病情严重程度,C3和β2微球蛋白具有评价脓毒症预后的潜在价值。

The diagnostic value of humoral and cellular immunity for sepsis

Objective To explore the diagnostic and prognostic value of cellular and humoral immunity indexes in sepsis patients.Methods A retrospective analysis was employed.144 sepsis inpatients were selected and divided into different subgroups,such as sepsis and severe sepsis;survivors and non-survivors.All patients’ humoral immunity and cellular immunity test results were collected in order to compare the significance of different immune parameters.Measurement data of non-normal distribution was under logarithmic conversion.Results Patients with severe sepsis group had significant lower C3,C4 and α2-globulin level than patients with sepsis groupsever sepsis vs.sepsis:(1.91±0.22)mg/dl vs.(2.02±1.02)mg/dl;(1.25±0.27)mg/dl vs.(1.40±0.31)mg/dl;(11.75±3.66)mg/dl vs.(14.06±3.07)mg/dl,P<0.05].Moreover,severe sepsis had significant higher β2-microglobulin levels(0.86±0.70 vs.0.34±0.15,P<0.05).Non-survivors group had significant lower C3 than survival patients(1.90±0.19)mg/dl vs.(1.98±0.18)mg/dl,P<0.05];β2-microglobulin levels higher than the survival patients(-0.18±0.38 vs.-0.40±0.28,P<0.05).Logistic regression analysis showed that β2-microglobulin was an independent risk factor of sepsis deaths.However,various indicators of cellular immunity in terms of different severity and prognosis in patients with sepsis were not found significant differences.Conclusions C3,C4,α2-globulin and β2-microglobulin could prompt sepsis severity,and C3 and β2-microglobulin could be used to evaluate sepsis prognosis.