Role of T lymphocytes apoptosis in immunosuppression and prognosis of cardiac arrest

Wang Yan-juan;Zhang Jun-li;Gu Wei;General Ward,Beijing Shunyi Hospital;  

Objective To observe the change rule of T lymphocyte subsets and cell apoptosis in patients with cardiac arrest(CA), so as to explore the clinical significance of the related immune assessment and prognosis prediction. Methods A total of 43 patients with CA who have been treated in the emergency department of Beijing Chaoyang Hospital from January 2014 to February 2018 were selected.By taking the survival rate on the 28 day of hospitalization as the end of observation, the patients were divided into the survival group and the death group. Changes of APACHE Ⅱ scores, T lymphocyte subsets levels and T lymphocyte apoptosis on the 1 st, 2 nd and 3 rd day after admission were analyzed. Results On the 1 st, 2 nd and 3 rd day after onset compared with normal control group, the apoptosis rate of T lymphocytes in peripheral blood increased significantly in CA patients(% : 17. 17 ±0. 56,18. 52 ±0. 60,20.24 ± 0. 90 vs. 9. 87 ±0.76, P 0. 05), and the T lymphocyte subsets decreased significantly(36.67 ± 0. 77,32. 44 ± 0. 80,25. 32 ± 0. 79 vs. 45. 10 ± 1. 05,P 0. 05). Compared with the survival group, the apoptosis of T lymphocytes in the death group increased significantly(% :29.16 ±7.82 vs. 41.76 ±1.83, 31.60 ±6.23 vs. 38.71 ±2.10, 33.14 ±5.16 vs. 37.24 ±3.28, P0.05),and the T lymphocyte subsets decreased significantly. In addition, the T lymphocyte subsets levels were significantly negatively correlated with APACHE Ⅱ scores, and the correlation coefficients are respectively-0.362(P=0.016) and-0.427(P=0.013). Conclusion Count of the T lymphocyte subsets is a good indicator to evaluate the immune function and outcomes of patients with CA. In the early stages of the resuscitation, the body appears increased T lymphocyte apoptosis and decreased T lymphocyte count significantly. A constantly decrease of T lymphocyte count indicates impaired immune function and increased mortality of patients.

【Fund】： 北京自然科學基金(7182055);; 北京市屬醫院科研培育計劃(PX2016022)
【CateGory Index】： R541.78

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