The relationship between coagulation, inflammatory factors, cellular immune function and severity of septic shock

Lijie SHEN

ABSTRACT

Objective:

To investigate the relationship between the coagulation function, inflammatory factors, cellular immune function and the severity of septic shock.

Methods:

From February 2018 to February 2019, 97 patients with septic shock admitted to Zhejiang Rongjun Hospital were divided into survival group(62 cases) and death group(35 cases) according to the prognosis of patients at 28 days after admission.Another 50 healthy physical examinees in Zhejiang Rongjun Hospital from February 2018 to February 2019 were selected as the control group.The changes of coagulation function were measured by automatic hemagglutination analyzer.C-reactive protein(CRP) and procalcitonin(PCT) were detected by electrochemiluminescence, and T-lymphocyte subsets were determined by flow cytometry.

Results:

The fibrinogen (Fib) and D-dimer (D-D) levels in the survival group [(3.54±0.25)g/L, (3.42±1.08)mg/L] and death group [(4.08±0.34)g/L and (5.31±1.45)mg/L] were higher than those in the control group [(3.17±0.38)g/L and (0.53±0.16)mg/L]( F=6.893, 13.245, all P<0.05). The levels of Fib and D-D in the survival group were lower than those in the death group ( P<0.05). The serum levels of CRP and PCT in the survival group [(48.85±6.57)g/L, (4.35±1.28)mg/L] and death group [(132.52±19.48)mg/L, (10.48±1.96)g/L] were higher than those in the control group [(2.76±0.63)mg/L, (0.10±0.03)g/L]( F=48.973, 13.241, all P<0.05). The levels of CRP and PCT in the survival group were lower than those in the death group(all P<0.05). The CD 3+ , CD 4+ and CD 4+ /CD 8+ in the survival group [(62.35±3.87)%, (37.48±2.86)%, (1.40±0.14)] and death group [(54.61±3.46)%, (33.09±2.15)%, (1.07±0.20)] were lower than those in the control group [(75.34±4.35)%, (43.87±1.90)% and (1.89±0.16)] ( F=6.893, 13.245, all P<0.05). The CD 3+ , CD 4+ and CD 4+ /CD 8+ in the survival group were higher than those in the death group( P<0.05). The APACHE Ⅱ score[(9.28±1.35)points] of the survival group was lower than that of the death group[(15.64±2.48)points]( t=16.383, P<0.05).

Conclusion:

The patients with septic shock have abnormal coagulation function, obvious inflammatory reaction and decreased immune function, and the coagulation function, inflammatory factors and cellular immune function are significantly related to the severity of the disease.