Predictive value of mitochondrial membrane potential changes in effector-memory T cells and inflammatory indicators for short-term neurological functional recovery in elderly patients with sepsis-associated encephalopathy

doi:10.3969/j.issn.1673-8640.2026.09.010

Abstract

Abstract:

Objective To investigate the value of mitochondrial membrane potential（MMP）indicators and inflammatory indicators of effector-memory T cells（Tem）in judging the short-term neurological functional recovery of elderly patients with sepsis-associated encephalopathy（SAE）. Methods A total of 158 elderly SAE patients from Huai'an Second People's Hospital from October 2020 to October 2025 were enrolled. They were classified into good recovery group and poor recovery group according to the neurological functional recovery status for 14 d after treatment. The clinical data were collected，and the T cell subsets，CD4⁺CD45RA^-CD62L^-Tem（referred to as CD4⁺ Tem）MMP and the percentage of low MMP cells in this subset of cells（referred to as CD4⁺Tem MMP-Low%），CD8⁺CD45RA^-CD62L^-Tem（referred to as CD8⁺Tem）MMP and the percentage of low MMP cells in this subset of cells（referred to as CD8⁺Tem MMP-Low%），whole blood cell counts，C-reactive protein（CRP）and procalcitonin（PCT）were determined. The neutrophil/lymphocyte ratio（NLR），systemic immune-inflammation index（SII），systemic inflammatory response index（SIRI）were calculated. Multivariate Logistic regression analysis was used to evaluate the influencing factors of poor neurological functional recovery in elderly SAE patients. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of single and combined determinations of various indicators in judging the poor short-term neurological functional recovery of elderly SAE patients. Results The CD4/CD8 ratio，CD4⁺Tem MMP，CD8⁺Tem MMP in poor recovery group were lower than those in good recovery group（P<0.001），while CD4⁺Tem MMP-Low%，CD8⁺Tem MMP-Low%，NLR，SII，SIRI，CRP and PCT were higher than those in good recovery group（P<0.001）. Decreased CD4/CD8 ratio and increased CD4⁺Tem MMP，CD8⁺Tem MMP，NLR were all risk factors for poor neurological functional recovery in elderly SAE patients（P<0.05）. The areas under curves（AUC）of CD4/CD8 ratio，CD4⁺Tem MMP，CD8⁺Tem MMP，NLR single and combined determinations in judging poor neurological functional recovery of elderly SAE patients were 0.669，0.679，0.717，0.720 and 0.835，respectively. Conclusions CD4/CD8 ratio，Tem MMP combined with NLR can effectively predict the short-term neurological functional recovery of elderly SAE patients and can provide a reference for early clinical intervention.

Key words: T cell subset, Mitochondrial membrane potential, Inflammatory indicator, Sepsis-associated encephalopathy, Neurological functional recovery, Elderly

CLC Number:

R446.63

SHI Yiwen, ZHANG Yajuan, LIU Yuan, ZHANG Yuanyuan, FU Jing. Predictive value of mitochondrial membrane potential changes in effector-memory T cells and inflammatory indicators for short-term neurological functional recovery in elderly patients with sepsis-associated encephalopathy[J]. Laboratory Medicine, 2026, 41(9): 884-890.

Figures/Tables 6

References 21

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组别	例数		年龄/岁		性别			高血压/ [例（%）]		糖尿病/ [例（%）]		脓毒症病程/d	SOFA 评分/分		GCS 评分/分
组别	例数		年龄/岁		男/[例（%）]		女/[例（%）]	高血压/ [例（%）]		糖尿病/ [例（%）]		脓毒症病程/d	SOFA 评分/分		GCS 评分/分
恢复不良组	90		78.59±6.55		53（58.9）		37（41.1）	55（61.1）		34（37.8）		3.39±1.19	6.00±1.90		11.20±2.25
恢复良好组	68		77.21±5.97		40（58.8）		28（41.2）	37（54.4）		27（39.7）		3.10±0.99	5.79±1.74		11.32±2.35
统计值			1.364		0.000			0.715		0.061		1.606	0.700		0.335
P值			0.175		0.993			0.398		0.805		0.110	0.485		0.738
组别		住院天数/d		脓毒症病因（感染部位）
组别		住院天数/d		肺部/[例（%）]		泌尿系统/[例（%）]			腹腔/[例（%）]		皮肤软组织/[例（%）]			其他部位/[例（%）]
恢复不良组		10.53±3.82		41（45.6）		27（30.0）			15（16.7）		6（6.7）			1（1.1）
恢复良好组		8.74±2.94		32（47.1）		20（29.4）			12（17.6）		3（4.4）			1（1.5）
统计值		3.523		0.439
P值		0.011		0.979

组别	例数		年龄/岁		性别			高血压/ [例（%）]		糖尿病/ [例（%）]		脓毒症病程/d	SOFA 评分/分		GCS 评分/分
组别	例数		年龄/岁		男/[例（%）]		女/[例（%）]	高血压/ [例（%）]		糖尿病/ [例（%）]		脓毒症病程/d	SOFA 评分/分		GCS 评分/分
恢复不良组	90		78.59±6.55		53（58.9）		37（41.1）	55（61.1）		34（37.8）		3.39±1.19	6.00±1.90		11.20±2.25
恢复良好组	68		77.21±5.97		40（58.8）		28（41.2）	37（54.4）		27（39.7）		3.10±0.99	5.79±1.74		11.32±2.35
统计值			1.364		0.000			0.715		0.061		1.606	0.700		0.335
P值			0.175		0.993			0.398		0.805		0.110	0.485		0.738
组别		住院天数/d		脓毒症病因（感染部位）
组别		住院天数/d		肺部/[例（%）]		泌尿系统/[例（%）]			腹腔/[例（%）]		皮肤软组织/[例（%）]			其他部位/[例（%）]
恢复不良组		10.53±3.82		41（45.6）		27（30.0）			15（16.7）		6（6.7）			1（1.1）
恢复良好组		8.74±2.94		32（47.1）		20（29.4）			12（17.6）		3（4.4）			1（1.5）
统计值		3.523		0.439
P值		0.011		0.979

组别	例数	CD4/CD8 比值	CD4⁺Tem MMP/mV	CD4⁺Tem MMP-Low%/%	CD8⁺Tem MMP/mV	CD8⁺Tem MMP-Low%/%
恢复不良组	90	1.26±0.30	109.2±18.94	28.59±5.68	108.81±15.93	32.48±6.92
恢复良好组	68	1.45±0.30	120.77±16.91	22.44±3.41	124.00±20.95	25.87±4.66
t值		3.942	3.978	7.906	5.176	6.790
P值		<0.001	<0.001	<0.001	<0.001	<0.001

组别	例数	CD4/CD8 比值	CD4⁺Tem MMP/mV	CD4⁺Tem MMP-Low%/%	CD8⁺Tem MMP/mV	CD8⁺Tem MMP-Low%/%
恢复不良组	90	1.26±0.30	109.2±18.94	28.59±5.68	108.81±15.93	32.48±6.92
恢复良好组	68	1.45±0.30	120.77±16.91	22.44±3.41	124.00±20.95	25.87±4.66
t值		3.942	3.978	7.906	5.176	6.790
P值		<0.001	<0.001	<0.001	<0.001	<0.001

组别	例数	NLR	SII（×10²）	SIRI（×10^-2）	CRP/（mg·L^-1）	PCT/（ng·mL^-1）
恢复不良组	90	5.98±2.18	21.45±8.02	5.40±2.20	92.15±33.57	1.71±0.67
恢复良好组	68	4.35±1.73	14.00±4.59	3.32±1.17	77.91±30.75	1.41±0.56
统计值		5.069	6.852	7.080	2.736	2.932
P值		<0.001	<0.001	<0.001	0.007	0.004