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已发表论文

脓毒症重症监护病房患者动态免疫指标变化对急性呼吸窘迫综合征的预测价值：一项回顾性研究

 

Authors Lu X, Chen Y, Zhang G, Zeng X, Lai L, Qu C 

Received 9 November 2024

Accepted for publication 15 February 2025

Published 1 March 2025 Volume 2025:18 Pages 1163—1172

DOI http://doi.org/10.2147/IJGM.S501252

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Héctor Mora-Montes

Xiaochi Lu,1 Yi Chen,1 Gongping Zhang,1 Xu Zeng,1 Linjie Lai,1 Chaojun Qu2 

1Department of Emergency Medicine, Lishui Municipal Central Hospital, Lishui, 323000, People’s Republic of China; 2Department of Intensive Care Unit, Lishui Municipal Central Hospital, Lishui, 323000, People’s Republic of China

Correspondence: Chaojun Qu, Department of Intensive Care Unit, Lishui Municipal Central Hospital, No. 289, Kuocang Road, Liandu District, Lishui, 323000, People’s Republic of China, Tel +86-0578-57079752, Email quchaojun6496@163.com

Background: Understanding the dynamic changes in immune indicators during sepsis and their predictive value for Acute respiratory distress syndrome (ARDS) is crucial for improving patient outcomes.
Methods: This single-center, observational retrospective study was conducted at Lishui Central Hospital, Zhejiang Province. Patients diagnosed with Sepsis-3 were categorized into non-ARDS and ARDS groups based on ARDS development. Data collection included demographics, clinical data, and immune parameters. Immune parameters were collected on days 1, 3, and 7 post-admission. Multivariate logistic regression analysis identified independent risk factors for ARDS, and a nomogram model was constructed. The predictive ability of the model was evaluated using ROC curves.
Results: Multivariate analysis identified key factors for the nomogram, including CD4, CD8, Treg, lymphocyte, IgG, and IgA levels on Days 3 and 7. On Day 3, CD8 (P < 0.001), Tregs (P = 0.021), IgG (P < 0.001), and IgA (P < 0.001) showed significant negative correlations with ARDS development. On Day 7, CD4 (P < 0.001), CD8 (P < 0.001), lymphocyte count (P < 0.001), and IgA (P < 0.001) similarly demonstrated significant negative correlations with ARDS risk. The nomogram model had an AUC of 0.998 (95% CI: 0.997– 0.999), indicating high predictive ability.
Conclusion: Early dynamic changes in immune indicators, including CD8, CD4, Treg, IgA, IgG, and Lymphocyte, predict ARDS development in ICU sepsis patients.

Keywords: sepsis, acute respiratory distress syndrome, immune indicator dynamics, nomograph, intensive care unit

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