Changes in peripheral blood T lymphocytes in sepsis patients with different blood glucose levels and their value in predicting prognosis

Kang Yanhong; Wei Junfeng; Kang Yi

doi:10.13406/j.cnki.cyxb.003941

您当前的位置：

首页 >

文章列表页 >

Changes in peripheral blood T lymphocytes in sepsis patients with different blood glucose levels and their value in predicting prognosis

Excellence in medical insights\：pathogenesis and clinical treatment of sepsis | 更新时间：2026-06-11

- Changes in peripheral blood T lymphocytes in sepsis patients with different blood glucose levels and their value in predicting prognosis
- Journal of Chongqing Medical University Vol. 51, Issue 6, Pages: 821-828(2026)
- 作者机构：
  
  郑州大学人民医院/河南省人民医院感染性疾病科，河南 450003
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.003941
  CLC： R459.7
- Received：15 April 2025，
  
  Revised：2025-07-04，
  
  Published：28 June 2026
- 稿件说明：
移动端阅览
康艳红,魏君锋,康谊.不同血糖水平脓毒症患者外周血T淋巴细胞变化及其对预后预测价值的探究[J].重庆医科大学学报,2026,51(06):821-828.

Kang Yanhong,Wei Junfeng,Kang Yi.Changes in peripheral blood T lymphocytes in sepsis patients with different blood glucose levels and their value in predicting prognosis[J].Journal of Chongqing Medical University,2026,51(06):821-828.
康艳红,魏君锋,康谊.不同血糖水平脓毒症患者外周血T淋巴细胞变化及其对预后预测价值的探究[J].重庆医科大学学报,2026,51(06):821-828. DOI： 10.13406/j.cnki.cyxb.003941.

Kang Yanhong,Wei Junfeng,Kang Yi.Changes in peripheral blood T lymphocytes in sepsis patients with different blood glucose levels and their value in predicting prognosis[J].Journal of Chongqing Medical University,2026,51(06):821-828. DOI： 10.13406/j.cnki.cyxb.003941.

摘要

目的

探究不同血糖水平脓毒症患者的外周血T淋巴细胞变化及其对患者预后的预测价值。

方法

回顾性选择2021年8月至2024年2月本院收治的脓毒症患者（

=170）为研究对象；根据不同空腹血糖（fasting plasma glucose，FPG）水平，分为A组（

=55，≤6.1 mmol/L）、B组（

=48，6.2~8.3 mmol/L）和C组（

=67，≥8.4 mmol/L）；根据患者的28 d预后情况，分为存活组（

=112）和死亡组（

=58）。对比分析各组患者的临床资料。调整混杂因素后，采用多元线性回归（multivariable linear regression，MLR）模型分析相关性。采用多因素logistic回归分析外周血T淋巴细胞亚群水平与28 d死亡风险的相关性。采用Kaplan-Meier法进行生存分析。

结果

与A组相比，B、C组患者的CD3

（

=7.439，

0.001；

=21.955，

0.001）、CD4

（

=6.215，

0.001；

=12.036，

0.001）水平均更低，CD8

（

=2.367，

=0.020；

=6.302，

0.001）水平均更高；与B组相比，C组患者的CD3

（

=12.688，

0.001）、CD4

（

=4.635，

0.001）水平均更低，CD8

水平均更高（

=3.829，

0.001）。FPG水平与CD3

（

=-0.397，

0.001）、CD4

（

=-0.348，

0.001）均呈负相关，与CD8

呈正相关（

=0.303，

0.001）。多因素分析显示，CD3

、CD4

、CD8

是28 d死亡风险的独立影响因素（均

趋势

0.001）。在不同FPG水平下，CD3

（

趋势

=0.006，0.001）、CD4

（

趋势

=0.004，

0.001）、CD8

（

趋势

=0.008，0.002）与28 d死亡风险的相关性稳定存在，且亚组间均存在交互作用（

交互

=0.033，0.025，0.041）。Kaplan-Meier分析显示，在FPG为6.2~8.3 mmol/L及≥8.4 mmol/L下，CD3

45.5%组患者的生存率明显低于≥45.5%组（

=6.842，

=0.009；

=9.376，

=0.002），CD4

44.6%组患者的生存率明显低于≥44.6%组（

=4.159，

=0.041；

=6.224，

=0.013），CD8

42.6%组患者的生存率明显低于≤42.6%组（

=5.317，

=0.021；

=7.518，

=0.006）。

结论

随着FPG水平的不断升高，脓毒症患者的CD3

、CD4

水平逐渐降低，而CD8

水平逐渐升高。CD3

、CD4

、CD8

水平对脓毒症患者预后判断具有较好的临床参考价值。

Abstract

Objective

To investigate the changes in peripheral blood T lymphocytes in sepsis patients with different blood glucose levels and their value in predicting prognosis.

Methods

A retrospective analysis was performed for 170 sepsis patients who were admitted to our hospital from August 2021 to February 2024. According to the level of fasting plasma glucose（FPG），they were divided into group A（55 patients with an FPG level of ≤6.1 mmol/L），group B （48 patients with an FPG level of 6.2-8.3 mmol/L），and group C（67 patients with an FPG level of ≥8.4 mmol/L）； according to the 28-day prognosis，they were divided into survival group with 112 patients and death group with 58 patients. Clinical data were compared between groups. After adjustment for confounding factors，the multiple linear regression model was used for correlation analysis. A multivariate logistic regression analysis was used to investigate the correlation between peripheral blood T lymphocyte subsets and the risk of 28-day mortality. The Kaplan-Meier method was used for survival analysis.

Results

Compared with group A，groups B and C had significantly lower levels of CD3

（

=7.439，

0.001；

=21.955，

0.001） and CD4

（

=6.215，

0.001；

=12.036，

0.001） and a significantly higher level of CD8

（

=2.367，

=0.020；

=6.302，

0.001），and compared with group B，group C had significantly lower levels of CD3

（

=12.688，

0.001） and CD4

（

=4.635，

0.001），and a significantly higher level of CD8

（

=3.829，

0.001）. The level of FPG was negatively correlated with CD3

（

=-0.397，

0.001） and CD4

（

=-0.348，

0.001） and was positively correlated with CD8

（

=0.303，

0.001）. The multivariate analysis showed that CD3

，CD4

，and CD8

were independent influencing factors for the risk of 28-day mortality（all

trend

0.001）. The correlation between CD3

（

trend

=0.006，0.001）/CD4

（

trend

=0.004，

0.001）/CD8

（

trend

=0.008，0.002） and

the risk of 28-day mortality remained stable under different FPG levels，and there were interactions between subgroups（

interaction

=0.033，0.025，and 0.041）. The Kaplan-Meier analysis showed that under an FPG level of 6.2-8.3 mmol/L or ≥8.4 mmol/L，the CD3

45.5% group had a significantly lower survival rate than the CD3

≥45.5% group（

=6.842，

=0.009；

=9.376，

=0.002）；the CD4

44.6% group had a significantly lower survival rate than the CD4

≥44.6% group（

=4.159，

=0.041；

=6.224，

=0.013）；the CD8

42.6% group had a significantly lower survival rate than the CD8

≤42.6% group（

=5.317，

=0.021；

=7.518，

=0.006）.

Conclusion

With the continuous increase in the level of FPG，the levels of CD3

and CD4

gradually decrease in sepsis patients，while the level of CD8

gradually increases. The levels of CD3

，CD4

，and CD8

have a good clinical reference value for predicting the prognosis of sepsis patients.

关键词

Keywords

references

Iwasaki K ， Okazaki A . Medication-related osteonecrosis of the jaw leading to sepsis in a patient with rheumatoid arthritis：a case report and clinical implications [J ] . Clin Case Rep ， 2023 ， 11 （ 6 ）： e7588 ．

Hu XQ ， Zhang J ， Wang PP ， et al . Practice and effect evaluation of early restrictive fluid resuscitation strategy in the nursing care of patients with sepsis in the emergency department：a retrospective cohort study [J ] . JBI Evid Implement ， 2023 ， 21 （ 3 ）： 269 - 276 ．

Reddan T ， Venugopal PS ， Powell J ， et al . Ultrasonographic assessment of aortic flow characteristics in a paediatric patient with sepsis treated with extracorporeal life support： defining the mixing zone [J ] . Australas J Ultrasound Med ， 2020 ， 23 （ 4 ）： 255 - 263 ．

Liang XH ， Luo HJ ， Chen X ， et al . Prognostic value of blood inflammatory parameters for predicting mortality in neonates with sepsis [J ] . Int Immunopharmacol ， 2023 ， 123 ： 110780 ．

Hale Z ， Thakkar M ， Morparia K . 1246： reversal of vasoplegic shock with methylene blue in a pediatric patient with severe sepsis [J ] . Crit Care Med ， 2021 ， 49 （ 1 ）： 628 ．

李　乐，罗苑苑，温敏勇 . 脓毒症中医证型分布、病原学特征及T淋巴细胞亚群与预后的相关性研究 [J ] . 广州中医药大学学报， 2023 ， 40 （ 2 ）： 271 - 277 ．

Li L ， Luo YY ， Wen MY . Study on the correlation of traditional Chinese medicine syndrome types，pathogenic features and T lymphocyte subsets with the prognosis of sepsis [J ] . J Guangzhou Univ Tradit Chin Med ， 2023 ， 40 （ 2 ）： 271 - 277 ．

Bai GX ， Cui N ， Wang H ， et al . T-lymphocyte subtyping： an early warning and a potential prognostic indicator of active cytomegalovirus infection in patients with sepsis [J ] . Immunol Cell Biol ， 2022 ， 100 （ 10 ）： 777 - 790 ．

张思也，侯　粲，钟燕军，等 . 脓毒症T淋巴细胞亚群免疫监测的研究进展 [J ] . 中华重症医学电子杂志（网络版）， 2021 ， 7 （ 1 ）： 48 - 54 ．

Zhang SY ， Hou C ， Zhong YJ ， et al . Review on advances of monitoring T-cell subsets in septic patients [J ] . Chin J Crit Care Intensive Care Med Electron Ed ， 2021 ， 7 （ 1 ）： 48 - 54 ．

中国医师协会急诊医师分会，中国研究型医院学会休克与脓毒症专业委员会 . 中国脓毒症/脓毒性休克急诊治疗指南（2018） [J ] . 临床急诊杂志， 2018 ， 19 （ 9 ）： 567 - 588 ．

Emergency Physician Branch of the Chinese Medical Association ， Shock and Sepsis Professional Committee of the Chinese Research Hospital Association . Guidelines for emergency treatment of sepsis/septic shock in China（2018） [J ] . J Clin Emerg ， 2018 ， 19 （ 9 ）： 567 - 588 ．

窦全亮，阿不都克力木·阿不都沙塔尔 . 不同血糖水平的尿源性脓毒血症患者临床特征分析 [J ] . 国际泌尿系统杂志， 2020 ， 40 （ 2 ）： 309 - 312 ．

Dou QL ， Abudushataer AKM . Clinical characteristics of uroseptic patients with different glycemic control levels [J ] . Int J Urol Nephrol ， 2020 ， 40 （ 2 ）： 309 - 312 ．

仇一然，元熙哲 . 脓毒症的研究进展综述 [J ] . 吉林医学， 2020 ， 41 （ 3 ）： 699 - 701 ．

Qiu YR ， Yuan XZ . Review on the research progress of sepsis [J ] . Jilin Med J ， 2020 ， 41 （ 3 ）： 699 - 701 ．

Zhang W ， Chen HZ ， Xu ZY ， et al . Liensinine pretreatment reduces inflammation，oxidative stress，apoptosis，and autophagy to alleviate sepsis acute kidney injury [J ] . Int Immunopharmacol ， 2023 ， 122 ： 110563 ．

宋艳丽，陈子阳，吴先正，等 . 胰岛素抵抗指数在脓毒症患者预后评估中的价值 [J ] . 同济大学学报（医学版）， 2020 ， 41 （ 1 ）： 63 - 67，71 ．

Song YL ， Chen ZY ， Wu XZ ， et al . The value of insulin resistance index in evaluation of prognosis in patients with sepsis [J ] . J Tongji Univ Med Sci ， 2020 ， 41 （ 1 ）： 63 - 67，71 ．

徐振江，徐洪雨 . T淋巴细胞亚群在炎症性肠病中作用的研究 [J ] . 胃肠病学和肝病学杂志， 2021 ， 30 （ 4 ）： 454 - 458 ．

Xu ZJ ， Xu HY . T lymphocyte subsets in inflammatory bowel disease [J ] . Chin J Gastroenterol Hepatol ， 2021 ， 30 （ 4 ）： 454 - 458 ．

关炳星，张　倩，马立良，等 . 脓毒症患者血清HMGB1、IGF-1水平变化及与T淋巴细胞亚群、预后的关系研究 [J ] . 现代生物医学进展， 2020 ， 20 （ 10 ）： 1984 - 1987，1965 ．

Guan BX ， Zhang Q ， Ma LL ， et al . Changes of serum HMGB1 and IGF-1 levels in sepsis patients and their relationship with T lymphocyte subsets and prognosis [J ] . Prog Mod Biomed ， 2020 ， 20 （ 10 ）： 1984 - 1987，1965 ．

Suri T ， Hadda V ， Chopra A ， et al . T-lymphocyte HLA-DR expression may predict early clinical outcomes in patients with sepsis [C ] // B45.CRITICAL CARE：SEPSIS IDENTIFICATION AND MANAGEMENT . American Thoracic Society ， 2020 ： A3489 - A3489 ．

朱成楼，陆　平，顾艳芬，等 . 脓毒血症患者不同血糖水平的临床特征及预后分析 [J ] . 中国医药科学， 2021 ， 11 （ 11 ）： 212 - 215 ．

Zhu CL ， Lu P ， Gu YF ， et al . Analysis on the clinical features and prognosis of patients with sepsis with different blood glucose levels [J ] . China Med Pharm ， 2021 ， 11 （ 11 ）： 212 - 215 ．

李丰帆，杨　磊，王东强，等 . T淋巴细胞亚群联合炎性指标对脓毒症的辅助诊断及预后评估价值 [J ] . 中华预防医学杂志， 2022 ， 56 （ 4 ）： 494 - 502 ．

Li FF ， Yang L ， Wang DQ ， et al . T lymphocyte subsets combined with inflammatory indicators for auxiliary diagnosis and prognosis evaluation of sepsis [J ] . Chin J Prev Med ， 2022 ， 56 （ 4 ）： 494 - 502 ．

Chen HY ， Zhang S ， Li J ， et al . Baicalein attenuates severe polymicrobial sepsis via alleviating immune dysfunction of T lymphocytes and inflammation [J ] . Chin J Integr Med ， 2022 ， 28 （ 8 ）： 711 - 718 ．

王　虎，张姣姣，孙俊楠，等 . 白介素-6联合CD4 + T淋巴细胞百分比对脓毒症患者预后的评估价值 [J ] . 内科理论与实践， 2021 ， 16 （ 6 ）： 404 - 408 ．

Wang H ， Zhang JJ ， Sun JN ， et al . Evaluating value of interleukin-6 combined with CD4 + T cell percentage on prognosis in patients with sepsis [J ] . J Intern Med Concepts Pract ， 2021 ， 16 （ 6 ）： 404 - 408 ．

Wang M ， Lv QB ， Zhao LD ， et al . Metoprolol and bisoprolol ameliorate hypertrophy of neonatal rat cardiomyocytes induced by high glucose via the PKC/NF-κB/c-fos signaling pathway [J ] . Exp Ther Med ， 2020 ， 19 （ 2 ）： 871 - 882 ．

张小彬，刘　丹，闫晶，等 . 脓毒症患者早期T淋巴细胞亚群和自然杀伤细胞水平与肠道损伤及预后的相关性研究 [J ] . 中华急诊医学杂志， 2020 ， 29 （ 5 ）： 682 - 687 ．

Zhang XB ， Liu D ， Yan J ， et al . Correlation between early T lymphocyte subsets and natural killer cell levels and intestinal injury and prognosis in patients with sepsis [J ] . Chin J Emerg Med ， 2020 ， 29 （ 5 ）： 682 - 687 ．

Shimobayashi M ， Thomas A ， Shetty S ， et al . Diet-induced loss of adipose hexokinase 2 correlates with hyperglycemia [J ] . Elife ， 2023 ， 12 ： e85103 ．

王君生 . 脓毒症患者外周血T淋巴细胞亚群及炎症因子水平与预后的关系研究 [J ] . 黑龙江医药科学， 2024 ， 47 （ 4 ）： 57 - 59 ．

Wang JS . Study on the relationship between T lymphocyte subsets and inflammatory factor levels in patients with sepsis [J ] . Heilongjiang Med Pharm ， 2024 ， 47 （ 4 ）： 57 - 59 ．

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Research progress on the relationship between uric acid and heart failure with preserved ejection fraction

Jianpi Rougan decoction alleviates carbon tetrachloride-induced liver fibrosis in rats by regulating ferroptosis mediated by the Nrf2/HMOX1 signaling pathway

Construction of a risk prediction model for sarcopenic obesity in the elderly based on machine learning

Role of interleukin-38 in regulating the expression of enzyme genes in the glutamine metabolic network of EL4 cells after T cell receptor signal activation

Analysis of the early diagnostic value of serum microRNAs in patients with sepsis complicated by liver injury

Related Author

Kang Yanhong

Kang Yi

Zhao Yisi

Zhang Mu

Yu Yingxi

Lin Shihui

Fan Jing

Liao Xiaohui

Related Institution

Department of Emergency and Critical Care Medicine,The First Affiliated Hospital of Chongqing Medical University

Department of Emergency Medicine and Critical Illness Medicine,The First Affiliated Hospital of Chongqing Medical University

Department of Nephrology,the Second Affiliated Hospital of Chongqing Medical University

Department of Intensive Medicine,the Affiliated Hospital of Hainan Medical College

Department of Intensive Care,Affiliated Hospital of Hainan Medical College

⁰