Peripheral Blood Lymphocyte Subsets Combined with Inflammatory Indexes to Monitor and Prognose Patients with Sepsis

Abstract

Background: This study aimed to investigate changes on inflammatory indexes in peripheral blood. Additionally, it evaluated the clinical value of lymphocyte subsets ratio for the prognosis of patients with sepsis on admission. Methods: A total of 147 patients with sepsis admitted to the Intensive Care Unit of Lishui People’s Hospital from June 2019 to June 2022 were selected. They were divided into ordinary sepsis group (N = 102) and septic shock group (N = 45). Healthy subjects from the health examination center of our hospital were selected as the control group (N = 80). Lymphocyte subsets in peripheral blood were determined by flow cytometry. Then they were divided into survival group (N = 105) and death group (N = 42) according to the 28-day survival result. Peripheral blood lymphocyte subsets were compared. Changes on peripheral blood inflammation indexes between admission and discharge were analyzed in the survival group with sepsis. Results: CD3+ cells (total T cells), CD3+CD8+ (suppressor T cells, Ts), CD3+CD4+ (helper T cells, Th), CD3-CD19+ (B cells), and CD3-CD16+/CD56+ (NK cells) in peripheral blood of patients with sepsis in ordinary sepsis group significantly decreased compared with healthy subjects (p < 0.05). There was no significant difference in NK (natural killer) cell percentage (NK %), Ts cell percentage (Ts %) and Th/Ts among ordinary sepsis group, septic shock group and healthy subjects (p > 0.05). T cells percentage (T %) and Th cells percentage (Th %) in septic shock group significantly decreased, and the percentage of B cells (B %) significantly increased compared with ordinary sepsis group (p < 0.05). CRP (C-reactive protein), PCT (procalcitonin) and Lac (lactic acid) in peripheral blood of the death group significantly increased, and the lymphocyte subsets T (Abs), Ts (Abs) and Th (Abs) significantly decreased compared with those in the survival group (p < 0.05). There was no significant difference in WBC (leukocyte, white blood cell), PLT (platelet) and NLR (neutrophil to lymphocyte ratio) between survival group and death group (p > 0.05). Conclusions: Further sepsis diagnosis and treatment can be achieved by monitoring changes on lymphocyte subsets in peripheral blood, and inflammatory indexes. Changes on the level of this subsets had an impact on the prognosis and improve the survival rate of patients with sepsis.