T细胞亚群水平可预测主动脉夹层患者入院30天生存状态

吴文飞.T细胞亚群水平可预测主动脉夹层患者入院30天生存状态[J].内科急危重症杂志,2024,30(5):425-428

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DOI：10.11768/nkjwzzzz.20240510

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基金项目:中山市医学科研项目（2019A020193）

作者	单位	E-mail
吴文飞	南方医科大学附属小榄人民医院	294696807@qq.com

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中文摘要:

摘要目的：探究主动脉夹层患者T细胞亚群水平与30d生存状态的关系。方法：收集184例接受手术治疗的主动脉夹层患者的临床资料，根据入院30d生存状态分为生存组（149例）和死亡组（35例），比较2组T细胞亚群（CD3+、CD3+CD4+、CD3+CD8+）水平。采用多元Logistic回归分析患者入院30d死亡的影响因素，受试者工作特征曲线分析CD3+、CD3+CD4+、CD3+CD8+T细胞的预测价值。结果：184例主动脉夹层患者入院30d内全因死亡35例（19.02%）。死亡组Stanford A型、低氧血症、高血压患者占比、入院收缩压及舒张压、CD3+CD8+T细胞水平高于生存组，CD3+与CD3+CD4+T细胞水平低于生存组（P均<0.05）。Logistic回归分析结果显示，CD3+CD8+T细胞、Stanford A型、低氧血症、高血压是主动脉夹层患者入院30d死亡的危险因素，CD3+、CD3+CD4+T细胞是其保护性因素（P均<0.05）。CD3+与CD3+CD4+、CD3+CD8+T细胞预测主动脉夹层患者入院30d死亡的曲线下面积分别为0.731（95%CI 0.644~0.819）、0.801（95%CI 0.726~0.875）、0.824（95%CI 0.731~0.918）。结论：主动脉夹层患者T细胞亚群CD3+、CD3+CD4+、CD3+CD8+水平与入院30d生存状态相关，三者与Stanford A型、低氧血症、高血压共同影响患者入院30d生存状态。

英文摘要:

Abstract Objective: To investigate the relationship between T cell subsets and 30-day survival status in patients with aortic dissection. Methods: The clinical data of 184 patients with aortic dissection who underwent surgical treatment were collected. The patients were divided into survival group (149 cases) and death group (35 cases) according to their survival status 30 days after admission, and T cell subsets (CD3+, CD3+CD4+, CD3+CD8+) in the two groups were compared. Multiple Logistic regression was used to analyze the influencing factors of death at 30 days after admission. The predictive value of CD3+, CD3+CD4+, CD3+CD8+T cells was analyzed by the ROC curve. Results: Among 184 patients with aortic dissection, 35 (19.02%) died of all causes within 30 days after admission. The proportions of Stanford type A, hypoxemia, hypertension, systolic and diastolic blood pressure on admission, and CD3+CD8+ T cells in the death group were higher than those in the survival group, and the levels of CD3+ and CD3+CD4+T cells in the death group were lower than those in the survival group(all P<0.05). Logistic regression analysis showed that CD3+CD8+, Stanford A type, hypoxemia and hypertension were risk factors for 30-day mortality in patients with aortic dissection, and CD3+, CD3+CD4+ T cells were protective factors (all P<0.05). The area under curve (AUC) of CD3+, CD3+CD4+ and CD3+CD8+ T cells were 0.731 (95%CI=0.644-0.819), 0.801 (95%CI=0.726-0.875) and 0.824 (95%CI=0.731-0.918) respectively in predicting the death of patients with aortic dissection at 30th day. Conclusion: The levels of CD3+, CD3+CD4+ and CD3+CD8+ T cell subsets in patients with aortic dissection are correlated with the survival status 30 days after admission, and the three factors together with Stanford type A, hypoxemia and hypertension affect the 30-day survival status of patients.