Journal of Internal Medicine Concepts & Practice >
Evaluating value of interleukin-6 combined with CD4+ T cell percentage on prognosis in patients with sepsis
Received date: 2021-03-18
Online published: 2022-07-25
Objective To evaluate the value of interleukin （IL）-6 combined with CD4+ T lymphocyte percentage on prognosis in the patients with sepsis. Methods The data of 158 patients with sepsis in the emergency medical department of our hospital from June 2016 to June 2019 were collected, which included IL-6 level, CD4+ T lymphocyte percentage, CD4+ T lymphocyte, C-reactive protein (CRP), procalcitonin (PCT）, human leukocyte DR antigen (HLA-DR), and calculation of patients’ sepsis-related organ failure assessment(SOFA) score and acute physiology and chronic health evaluation-Ⅱ (APACHE Ⅱ) score within 24 h after admission. The patients were divided into survival group and death group according to the prognosis after 28 d, and the difference of the SOFA score, APACHE Ⅱ score, IL-6, CD4+ T lymphocyte percentage, the correlation between IL-6, CD4+ T lymphocyte percentage and SOFA score was analyzed, the receiver operating characteristic (ROC) curve was drawn, and the prognostic value of IL-6, CD4+ T lymphocyte percentage and their combination on the patients with sepsis was evaluated. Results APACHE Ⅱ score (t=4.514, P<0.001), SOFA score (t=4.711, P<0.001), IL-6 (Z=2.114, P=0.035), PCT (t=2.192, P=0.021),CRP (Z=2.208, P=0.033) and D-dimmer (Z=1.963, P=0.043) in the death group were significantly higher than those in the survival group, while the percentage of CD4+ T lymphocytes (Z=2.398, P=0.016) and HLA-DR(t=2.004,P=0.040) in the death group were significantly lower than that in the survival group. Spearman correlation analysis of IL-6, CD4+ T lymphocyte percentage and SOFA showed that IL-6 was positively correlated with SOFA score (r=0.478, P<0.001) and APACHEⅡscore(r=0.351, P=0.024). CD4+ T lymphocyte percentage was negatively correlated with SOFA score(r=-0.305, P=0.043) and APACHEⅡscore(r=-0.347, P=0.031). ROC curve showed that IL-6 combined with CD4+ T lymphocyte percentage [area under the curve(AUC)=0.793] had better prognostic value for the patients with sepsis than both APACHE Ⅱ score(AUC=0.732) and SOFA score(AUC=0.750), with sensitivity of 86.7% and specificity of 63.0%. The predictive effect of the combination of two factors was better than that of single index. Conclusions IL-6 combined with CD4+T lymphocyte percentage can evaluate the prognosis of the patients with sepsis, and the combination of two indexed is better than using single index.
Key words： Sepsis; Interleukin-6; Percentage of CD4+ T lymphocytes
WANG Hu, ZHANG Jiaojiao, SUN Junnan, WANG Hairong . Evaluating value of interleukin-6 combined with CD4+ T cell percentage on prognosis in patients with sepsis[J]. Journal of Internal Medicine Concepts & Practice, 2021 , 16(06) : 404 -408 . DOI: 10.16138/j.1673-6087.2021.06.007
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