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1、【隅l】國(guó)熬呈溺斟蘸德醫(yī)毽學(xué)髓·919··論著·淋巴細(xì)胞亞群預(yù)測(cè)膿毒癥患者死亡風(fēng)險(xiǎn)的主成分分析潘東峰,李富榮,梁詩(shī)頌,祁科樂(lè),季新忠,柯進(jìn)芳【摘要】目的探討淋巴細(xì)胞亞群對(duì)膿毒癥患者死亡風(fēng)險(xiǎn)的預(yù)測(cè)價(jià)值。方法選取2012年3月—2013年12月寧夏人民醫(yī)院急診重癥監(jiān)護(hù)室及重癥監(jiān)護(hù)室收治的膿毒癥患者101例為研究對(duì)象,按預(yù)后將患者分為存活組(8O例)和死亡組(21例)。人院48h內(nèi)檢測(cè)淋巴細(xì)胞亞群水平,應(yīng)用主成分分析提取綜合預(yù)測(cè)因子,評(píng)估淋巴細(xì)胞亞群對(duì)膿毒癥患者死亡風(fēng)險(xiǎn)的預(yù)測(cè)價(jià)值。結(jié)果不同類型的膿毒癥患者總T淋巴細(xì)胞、總B淋巴細(xì)胞
2、、輔助/調(diào)節(jié)T淋巴細(xì)胞(Th)、抑制/細(xì)胞毒T淋巴細(xì)胞(Ts)、Th/Ts和總NK細(xì)胞表達(dá)水平比較,差異均有統(tǒng)計(jì)學(xué)意義(P<0.05)。嚴(yán)重膿毒癥患者中,死亡組Ts表達(dá)水平低于生存組(P<0.05);膿毒性休克患者中,死亡組rI’}l表達(dá)水平低于生存組(P<0.05)。淋巴細(xì)胞亞群綜合預(yù)測(cè)因子預(yù)測(cè)膿毒癥患者死亡風(fēng)險(xiǎn)的受試者工作特征曲線下面積為0.983[95%C/(0.934,0.998)]。結(jié)論膿毒癥患者淋巴細(xì)胞亞群表達(dá)異常,淋巴細(xì)胞亞群綜合預(yù)測(cè)因子對(duì)膿毒癥患者的死亡風(fēng)險(xiǎn)有較高的預(yù)測(cè)價(jià)值。【關(guān)鍵詞】膿毒癥;淋巴細(xì)胞亞群;預(yù)
3、后;主成分分析【中圖分類號(hào)】R63l_2【文獻(xiàn)標(biāo)識(shí)碼】Adoi:10.3969/j.issn.1007—9572.2015.08.015潘東峰,李富榮,粱詩(shī)頌,等.淋巴細(xì)胞亞群預(yù)測(cè)膿毒癥患者死亡風(fēng)險(xiǎn)的主成分分析[J].中國(guó)全科醫(yī)學(xué),2015,18(8):919—923.[WWW.chinagp.net]PanDF,LiFR,LiangSS,eta1.Lymphocytesubsetstopredicttheprincipalcomponentofriskofdeathinsepsispatients[J].ChineseGe
4、neralPractice,20t5,i8(8):919—923.LymphocyteSubsetstoPredictthePrincipalComponentofRiskofDeathinSepsisPatientsPANDong—feng,LIFu—rong,LIANGShi—song,eta1.DepartmentofEmergency,NingxiaPeopleSHospital,Yinchuan750021,China【Abstract】ObjectiveToobservethepredictivevalueofl
5、yrephocytesubsetsformortalityriskinsepsispatients.MethodsFromMarch2012toDecember2013,101sepsispatientswereenrolledinthisstudyanddividedinEICUandICUoftheNingxiaPeopleSHospital,accordingtoprognosis,intogroupssurvival(n=80),death(n=21).Theleveloflymphocytesubsetswered
6、etectedat48hoursafteradmission,andcomprehensivepredictorwasextractedbyprincipalcomponentanalysis.ThepredictivevaluesoflymphocytesubsetsformortalityriskofsepsispatientsWereevaluated.ResultsTherewassignificantdifferenceintotalTlymphocytes,totalBlymphocytes,helper/reg
7、ulatoryTlymphocytes(Th),suppressor/cytotoxicTlymphocytes(Ts),Th/Ts,totalNKcellsbetweendifferenttypesofsepsispatients(P<0.05).Inseveresepsispatients,suppressor/cytotoxicTlymphocyteswerelowerindeathgroupthaninsurvivalgroup(P<0.05);insepticshockpatients,auxiliary/regu
8、latoryTlymphocyteswerelowerindeathgroupthaninsurvivalgroup(P<0.05).Theareaunderthereceiver—operatingcurveoflymphocytesubsetscomprehensivepredicto