Value of of IgG4 and Th17/Treg in serum in evaluation of effect of hormone therapy for AIP patients
Objective To analyze serum immunoglobulin 4(IgG4)and helper T 17(Th17)/regulatory T cells(Treg)in the assessment of response to hormone therapy in patients with autoimmune pancreatitis(AIP).Methods A total of 95 patients with AIP treated at Tongchuan People's Hospital from April 2021 to September 2023 were selected,including 55 males and 40 females;they were(54.28±5.51)years old;48 cases had smoking history;49 cases had drinking history.Before the treatment,the flow cytometry was used to detect Th17 and Treg,and Th17/Treg was calculated.The level of AMY was detected by the enzyme-linked immunosorbent assay.All the patients took hormone therapy,and were divided into an effective group(complete response and partial response)and an ineffective group(treatment failure)according to the effect.The basic data and serological indicators of the two groups were compared to analyze the influencing factors and predictive value of serum IgG4 and Th17/Treg for evaluating the efficacy of hormone therapy for the patients.tandx2 tests were used.The binary logistic stepwise regression model was used to analyze the influencing factors.The receiver operating characteristic curve(ROC)was drawn to evaluate the prediction efficacy.Results After hormone therapy for the patients,43 patients had complete remission,30 partial remission,and 22 treatment failure.The effective rate was 75.00％(73/95),and the ineffective rate 23.16％(22/95).The Th17/Treg and levels of D-D,AMY,and IgG4 in the effective group were lower than those in the ineffective group[(1.05±0.14)vs.(2.21±0.34),(0.23±0.05)mg/L vs.(0.52±0.12)mg/L,(296.56±15.74)U/L vs.(436.26±18.52)U/L,and(2.47±0.41)g/L vs.(4.62±0.78)g/L],with statistical differences(t=23.475,16.556,35.005,and 17.091;all P＜0.001).The binary logistic regression analysis results showed that the Th17/Treg(OR=4.486,95％CI 1.533-13.125)and levels of D-D(OR=3.333,95％CI 1.139-9.753),AMY(OR=3.912,95％CI 1.337-11.445),and IgG4(OR=3.077,95％CI 1.052-9.003)were the influential factors for the efficacy of hormone therapy for the patients(all P＜0.05).According to the ROC analysis,the sensitivities of Th17/Treg,D-D,AMY,IgG4,and their combination in the prediction of the ineffectiveness of hormone therapy for the patients were 77.27％,63.64％,68.18％,72.73％,and 90.91％,respectively;the specificities were 76.71％,68.49％,69.86％,73.97％,and 91.78％,respectively.Conclusions Th17/Treg and the levels of D-D,AMY,and IgG4 are related to the ineffective hormone therapy for patients with A1P;the combined detection is more accurate and efficient in predicting the efficacy of hormone therapy for patients with AIP.
万方数据
维普
