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CD4+ lymphocyte adenosine triphosphate determination in sepsis: a cohort study

机译：败血症中CD4 +淋巴细胞三磷酸腺苷的测定：一项队列研究

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IntroductionPatients suffering from sepsis are currently classified on a clinical basis (i.e., sepsis, severe sepsis, septic shock); however, this clinical classification may not accurately reflect the overall immune status of an individual patient. Our objective was to describe a cohort of patients with sepsis in terms of their measured immune status.MethodsFifty-two patients with sepsis (n = 13), severe sepsis (n = 21), or septic shock (n = 18) were studied. The immune status was determined by measuring the CD4+ lymphocyte adenosine triphosphate (ATP) content after mitogen stimulation in whole blood.ResultsThe measured CD4+ lymphocyte ATP content at the time of ICU admission did not differ among the various groups defined by the sepsis classification system (sepsis = 454 ± 79 ng/ml; severe sepsis = 359 ± 54 ng/ml; septic shock = 371 ± 53 ng/ml; P = 0.44). Furthermore, survivors of sepsis had a significantly higher CD4+ lymphocyte ATP content at the time of ICU admission than did nonsurvivors of sepsis (431 ± 41 ng/mL vs. 266 ± 53 ng/mL, respectively; P = 0.04).ConclusionsThe sepsis classification system that is currently used is not representative of the individual immune status as determined by measuring the CD4+ lymphocyte ATP content. Moreover, a lower CD4+ ATP content at the time of ICU admission is associated with a worse clinical outcome in those suffering from sepsis.
机译：引言目前，患有败血症的患者根据临床分类（即败血症，严重败血症，败血性休克）;但是，这种临床分类可能无法准确反映单个患者的总体免疫状况。我们的目的是根据测量的免疫状况描述一群脓毒症患者。方法研究了52例脓毒症（n = 13），严重脓毒症（n = 21）或败血性休克（n = 18）的患者。通过测量全血中有丝分裂原刺激后CD4 +淋巴细胞三磷酸腺苷（ATP）含量来确定免疫状态。结果在ICU入院时，脓毒症分类系统（败血症）所定义的各组之间测量的CD4 +淋巴细胞ATP含量没有差异。 = 454±79 ng / ml;严重败血症= 359±54 ng / ml;败血性休克= 371±53 ng / ml; P = 0.44）。此外，败血症幸存者在ICU入院时的CD4 +淋巴细胞ATP含量明显高于非败血症幸存者（分别为431±41 ng / mL和266±53 ng / mL; P = 0.04）。通过测量CD4 +淋巴细胞ATP含量确定的当前使用的免疫系统不能代表个体免疫状态。而且，在患有败血症的患者中，ICU入院时CD4 + ATP含量较低与临床效果较差有关。

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