首页|CD4+T细胞亚群对白塞病患者复发葡萄膜炎的临床评估价值

CD4+T细胞亚群对白塞病患者复发葡萄膜炎的临床评估价值

Clinical evaluation value of CD4+T lymphocyte subsetsin patients with recurrent uveitis in Beh?et's disease

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目的 探讨CD4+T细胞亚群如辅助性T细胞(Th)指标在白塞病患者复发葡萄膜炎(BU)的临床评估价值.方法 回顾性分析2020年1月1日至2023年6月30日于山西医科大学第二医院诊断为白塞病的153例住院患者的临床资料,CD4+T细胞亚群测定如Th1、Th2、Th17以及调节性T细胞(Treg细胞)和细胞因子、血脂生化指标(TC、TG等)、患者近1年口腔溃疡发生次数、近1年生殖器溃疡发生次数和患者入院前用药情况等;根据有无累及眼部并且发生葡萄膜炎将153例白塞病分为白塞非葡萄膜炎组(非BU组)和白塞葡萄膜炎组(BU组).比较BU组与非BU组以上指标水平以及白塞病复发BU的独立相关因素;比较BU组与非BU组的细胞因子及国际白塞病标准(ICBD)总评分水平、ICBD总评分与各细胞因子的相关性和分析Th2细胞诊断性能.统计学方法采用Mann-Whitney U检验、独立样本t检验、x2检验、多元logistic回归分析、Pearson相关分析和受试者操作特征曲线(ROC)分析.结果 ①BU组患者Th1、Th2、Th17 细胞、TC、TG 的水平分别高于非 BU 组[133.87(93.38,229.87)个/μl 与 102.51(64.25,149.23)个/μl]、[9.43(5.84,14.13)个/μl 与 6.78(4.23,9.44)个/μl]、[15.53(9.36,25.27)个/μl 与9.83(5.46,14.76)个/μl]、[4.21(3.89,4.90)mmol/L 与 3.89(3.37,4.34)mmol/L]、[1.43(1.00,2.21)mmol/L 与0.96(0.69,1.38)mmol/L],差异均有统计学意义(Z=-3.24,-3.05,-3.94,-2.25,-3.47;P值均<0.05);2 组患者入院前用药情况比较差异无统计学意义(x2=5.69,P>0.05)o②BU组的IL-2、IL-10水平、ICBD总评分高于非BU组,差异均有统计学意义(Z=-2.12,-2.29,t=-6.48;P值均<0.05).③多元logistic回归分析结果显示,Th2是BU独立相关因素[OR值(95%置信区间)为1.143(1.007,1.298),P=0.039].BU患者总评分与Th2、Th17细胞呈正相关(r=0.23,P=0.006;r=0.21,P=0.013).ROC分析结果显示Th2诊断BU的灵敏度为68.8%,特异度为49.5%,曲线下面积(95%置信区间)为0.697(0.585,0.809)(P=0.001).结论 Th2细胞绝对数水平等与BU相关,是观察BU患者病情进展严重程度的重要指标,在评估白塞病患者复发BU有一定的临床价值.
Objective To evaluate the clinical value of CD4+T lymphocyte subsets such as helper Th2 in patients with recurrent uveitis(BU)in Behçet's disease(BD).Methods The clinical data of 153 hospitalized patients diagnosed with Behçet's disease from January 1,2020 to June 30,2023 in the Second Hospital of Shanxi Medical University were retrospectively analyzed.The subsets of CD4+T lymphocytes were measured,including helper T cells(Th cells)such as Th1,Th2,Th17 and regulatory T cells(Treg cells),biochemical lipid indexes(TC,TG,etc.),the frequency of oral ulcers in the past 1 year,the frequency of genital ulcers in the past 1 year,and drug use before admission;According to whether there was ocular involvement and uveitis,153 cases of BD were divided into Behçet non-uveitis group(non-BU group)and Behçet uveitis group(BU group).The above indexes and independent correlation factors of recurrent BU were compared between BU group and non-BU group;The above indexes and independent correlation factors of recurrent BU were compared between BU group and non-BU group.The levels of cytokines and ICBD total score,the correlation between ICBD total score and various cytokines,and the diagnostic performance of Th2 cells were compared between BU group and non-BU group.The statistical methods were Mann-Whitney U test,independent sample t test,Chi-square test,multiple logistic regression analysis,Pearson correlation analysis and receiver operating characteristic curve(ROC)analysis.Results ①The levels of Th1,Th2.Th17 cells,TC and TG in BU group were higher than those in non-BU group[133.87(93.38,229.87)/μl vs.102.51(64.25,149.23)/μl]and[9.43(5.84,14.13)/μl vs.6.78(4.23,9.44)/μl],[15.53(9.36,25.27)/μl vs.9.83(5.46,14.76)/μl],[4.21(3.89,4.90)mmol/L vs.3.89(3.37,4.34)mmol/L)],[1.43(1.00,2.21)mmol/L vs.0.96(0.69,1.38)mmol/L],The differences were statistically significant(Z=-3.24,Z=-3.05,Z=-3.94,Z=-2.25,Z=-3.47;all P<0.05);There was no statistical significance in Chi-square test between the two groups(x2=5.69,P>0.05).②The levels of IL-2,IL-10 and total ICBD score in BU group were higher than those in non-BU group,with statistical significance(Z=-2.12,Z=-2.29,t=-6.48;all P<0.05).③ The results of multiple logistic regression analysis showed that Th2 was an independent correlation factor for BU[OR value(95%CI)was 1.143(1.007,1.298),P=0.039].The total score of BU patients was correlated with Th2 and Th17 cells.ROC analysis showed that the sensitivity of Th2 in diagnosing BU was 68.8%,the specificity was 49.5%and the area under the curve(95%CI)was 0.697(0.585,0.809)(P=0.001).Conclusion CD4+T lymphocyte subsets such as the absolute number of Th2 cells are related to BU,which is an important indicator to observe the severity of disease progression in BU patients,and has certain clinical value in evaluating the recurrence of BU in BD patients.

Behçet sydromeUveitisT lymphocytes

逯世林、张娜、张莎、刘伟、李小青、关坤萍、罗静、李晓东、石磊、王彩虹

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山西医科大学第二医院检验科,太原 030001

山西医科大学第二医院风湿科,太原 030001

贝赫切特综合征 葡萄膜炎 T淋巴细胞

2024

中华风湿病学杂志
中华医学会

中华风湿病学杂志

CSTPCD
影响因子:0.651
ISSN:1007-7480
年,卷(期):2024.28(6)
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