关键词: 脓毒症, 全身炎症反应综合征, 代谢综合征X, T淋巴细胞, 预后

Abstract: Objective　To investigate the characteristics of immune status in patients with sepsis complicated by different stages of metabolic syndrome（MS），and their effects on prognosis.Methods　A total of 200 patients with sepsis who were hospitalized in the Department of Emergency ，the Second Affiliated Hospital of Hainan Medical University between January 2014 and June 2017 were prospectively selected and divided into the following four groups according to the presence of MS complication and MS status：MS systemic inflammatory syndrome group（MSS group，50 cases），MS severe sepsis group（MSSS group，50 cases），non-MS systemic inflammatory syndrome group（NMSS group，50 cases） and non-MS severe sepsis group（NMSSS group，50 cases）．A control group included 50 persons who received a health examination in our hospital.Patients with sepsis were also divided into a survival subgroup and a death subgroup.The peripheral blood T-lymphocyte-related immunological indicators（CD3+T，CD4+T，CD8+T，CD4+T/CD8+T） in each group were tested and compared.Results　The Acute Physiology and Chronic Health Evaluation systemⅡ（APACHE Ⅱ） and sequential organ failure assessment（SOFA） scores in the MSSS group were higher than those in the MSS group（P<0.05），and the APACHE Ⅱand SOFA scores in the NMSSS group were higher than those in the NMSS group（P<0.05）．The SOFA score in the MSSS group was higher than that in the NMSSS group（P<0.05）．The percentages of T lymphocytes in the sepsis groups were all lower than that in the control group（P<0.05）．The levels of CD+3T，CD+4T and CD+8T cells were lower in the MSSS group and NMSSS group than the MSS group （P<0.05），and lower in the MSSS group than the NMSSS group（P<0.05）．The MSSS and NMSSS groups had higher mortality than did the MSS and NMSS groups（P<0.05），and the mortality in the MSSS group was higher than that in the NMSSS group （P<0.05）．The APACHE Ⅱ and SOFA scores，and the incidence of MS in the death subgroup were all higher than those in the survival subgroup，and the levels of CD+3T，CD+4T，CD+8T and CD+4T/CD+8 T were lower in the death subgroup than the survival subgroup（P<0.05）．Conclusion　MS aggravates immunosuppression and disease severity in patients with sepsis and affects their prognosis.

Key words: Sepsis, Systemic inflammatory response syndrome, Metabolic syndrome X, T-lymphocytes, Prognosis