To investigate the clinical value of t MCP-1 and monocyte human leukocyte antigen-DR (mHLA-DR) in severity and the prognosis of sepsis patients.

104 patients with sepsis were selected. Patients were classified into two groups (survival group (63 cases) and non-survival group (41 cases). Venous blood was collected in all patients within 12 hours after admission, and sequential organ failure assessment (SOFA) score and acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score were documented. Serum MCP-1 was detected by ELISA method and peripheral blood mHLA-DR by flow cytometer. We compared the differences between the two groups, and drew the receiver-operating characteristic curve (ROC) to investigate the clinical value of different indicators for the prognosis of sepsis patients. And we further analyzed the relationship between the MCP-1 and the mHLA-DR.

For all the enrolled sepsis patients, the expression of serum MCP-1 in non-survival group was significantly higher than in survival group [(187.65±60.73) pg/ml vs (90.83±31.58) pg/ml, t=-10.65, P<0.01]. The level of the mHLA-DR in survival group was higher than non-survival group [(54.70±12.21) % vs (29.41±8.78)% t=11.47, P<0.05]. The SOFA score in non-survival group was higher than in survival group [(11.76±3.92) vs (9.17±4.39), t=-3.28, P<0.01]. The APACHEⅡ score in non-survival group was significantly higher than in survival group [(25.76±6.27) vs (18.83±4.65), t=-6.47, P<0.05]. The MCP-1 death area under the curve (AUC) was 0.950 (P<0.001, 95%CI: 0.911-0.989), and the cut-off point was 115.48pg/ml, the sensitivity was 90.2%, the specificity was 87.3%. The mHLA-DR survival area under the curve (AUC) was 0.952 (P<0.001, 95%CI: 0.915-0.990), and the cut-off point was 39.3%, the sensitivity was 88.9%, the specificity was 87.8%. The SOFA score death area under the curve (AUC) was 0.690 (P<0.002, 95%CI: 0.591-0, 790), and the cut-off point was 8.5 points, the sensitivity was 80.5%, the specificity was 57.1%. The APACHEⅡ score death area under the curve (AUC) was 0.805 (P<0.001, 95%CI: 0.711-0.898), and the cut-off point was 22.5 points, the sensitivity was 75.6%, the specificity was 76.2%. The MCP-1 expression was negatively correlated with the mHLA-DR level (r=-0.872, P<0.01).

The expression of serum MCP-1 and peripheral blood mHLA-DR in sepsis patients can reflect the degree of disease, and help assess patients′ prognosis.