Objective To investigate the clinical application of peripheral blood type 1 or type 2 helper T lymphocyte(Th1/Th2) cytokine profiles in patients with different infection degrees, and their evaluation value of short-term prognosis in patients with sepsis.
Methods Seventy-eight patients with sepsis, 64 patients with local infection and 42 patients without infection were divided into the sepsis group, common infection group and non-infection group, respectively.The clinical data of three groups were collected, and the cytokine concentrations among three groups were compared after hospitalization, and the Spearman grade correlation was used to predict their relationship with infection severity.According to the follow-up results, the sepsis patients were divided into the survival group(31 cases) and death group(47 cases), and the differences of Th1/Th2 cytokine profiles between two groups were compared.The independent risk factors affecting prognosis of sepsis patients were screened by logistic regression analysis, and the 28 d survival rate of sepsis patients was analyzed in two subgroups.Kaplan-Meier survival curve was drawn to analyze the 28 d cumulative survival of patients.
Results With the increasing of infection severity, the level of IL-4 decreased gradually, while the levels of IL-6, IL-8 and IL-10 increased gradually.The levels of IL-5 in the sepsis group and common infection group were lower than that in non-infection group(P < 0.05 to P < 0.01).The results of Spearman correlation analysis that showed the IL-4 was significantly negatively correlated with infection severity(P < 0.01), and the levels of IL-6, IL-8 and IL-10 were positively correlated with the severity of infection(P < 0.01).After 28 d of follow-up, the mortality of sepsis patients was 60.26%.The concentrations of IL-5, IL-6, IL-8 and IL-10 in the death group were higher than those in survival group(P < 0.05 to P < 0.01).The results of logistic regression analysis showed that the IL-5 and IL-8 were the independent risk factors of 28 d death in sepsis patients(P < 0.05).The IL-5 and IL-8 were subgrouped according to the optimal cut-off value, and the results suggested that the increasing of IL-5 and IL-8 increased the risk of 28 d death in sepsis patients.Kaplan-Meier survival analysis further confirmed that the 28 d cumulative survival rate in the IL-5≥0.55 pg/mL group was significantly lower than that in the IL-5 < 0.55 pg/mL group(P < 0.05).The 28 d cumulative survival rate in IL-8≥54.61 pg/mL group was significantly lower than that in IL-8 < 54.61 pg/mLgroup(P < 0.01).
Conclusions There is a significant correlation between Th1/Th2 cytokine profiles and the severity of infection, and IL-5 and IL-8 have good predictive value for 28 d death of sepsis patients.
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