摘要
目的分析反复呼吸道感染患儿体内的微炎性反应水平与外周血T淋巴细胞亚群的相关性。方法选择2017年2月—2019年6月诊断为反复呼吸道感染的患儿120例作为感染组,同期门诊体检正常儿童120例为对照组。检测2组的外周血T淋巴细胞亚群指标,并检测血清超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、IL-17、转化生长因子-β1(TGF-β1)、降钙素原(PCT)水平和中性粒细胞/淋巴细胞比例(NLR)。分析Treg T淋巴细胞比例和Th17/Treg比值与NLR、hs-CRP、IL-6、TGF-β1的相关性,并分析Th1/Th2、Th17/Treg、Treg T淋巴细胞比例对反复呼吸道感染的诊断效能。结果与对照组比较,感染组的外周血CD4+T淋巴细胞比例、CD4+/CD8+、Th1/Th2、Th17/Treg比值降低,血清hs-CRP、NLR、IL-6、TGF-β1水平升高,IL-17水平降低(P<0.05)。2组血清PCT水平比较差异无统计学意义(P>0.05)。Treg T淋巴细胞比例与NLR、hs-CRP、IL-6、TGF-β1呈直线正相关(P<0.05),Th17/Treg比值与NLR、hs-CRP、IL-6、TGF-β1呈直线负相关(P<0.05)。以Th1/Th2≤7.65为截断值,其诊断灵敏度为78.46%,特异性为83.42%。以Th17/Treg≤0.43为截断值,其诊断灵敏度为81.24%,特异性为88.70%。以Treg T淋巴细胞比例≥32.28%为截断值,其诊断灵敏度为84.35%,特异性为87.92%。结论反复呼吸道感染患儿体内存在免疫炎性反应失衡。Treg T淋巴细胞比例、Th17/Treg比值与血清炎性因子水平存在相关性。外周血Th1/Th2、Th17/Treg、Treg T淋巴细胞比例对反复呼吸道感染具有一定诊断价值。
Objective To analyze correlation between level of micro-inflammatory reaction and T lymphocyte subsets in peripheral blood in children with recurrent respiratory tract infection.Methods A total of 120 children with recurrent respiratory tract infection diagnosed during February 2017 and June 2019 were selected as infection group,and other 120 healthy children with physical examination at the same period were selected as control group.In two groups,T lymphocyte subsets indexes in peripheral blood were tested,and serum high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),IL-17,transforming growth factor-β1(TGF-β1),procalcitonin(PCT)levels and neutrophil/lymphocyte ratio(NLR)were also detected.Correlations between Treg T lymphocyte ratio and Th17/Treg ratio with NLR,hs-CRP,IL-6 and TGF-β1 were analyzed,and efficiency of Th1/Th2,Th17/Treg and Treg T lymphocyte ratio in diagnosis of recurrent respiratory infection was analyzed.Results Compared with those in control group,values of proportion of CD4+T lymphocytes in peripheral blood,CD4+/CD8+,Th1/Th2 and Th17/Treg ratio were decreased,while serum hs-CRP,NLR,IL-6,TGF-β1 levels were increased,and IL-17 level was decreased in infection group(P<0.05).There was no significant difference in serum PCT level between two groups(P>0.05).Treg T lymphocytes ratio showed positive linear correlation with NLR,hs-CRP,IL-6 and TGF-β1(P<0.05),while Th17/Treg ratio showed negative linear correlation with NLR,hs-CRP,IL-6 and TGF-β1(P<0.05).Th1/Th2 equal or less than 7.65 was used as cutoff value,and diagnostic sensitivity and specificity were 78.46%and 83.42%respectively.Th17/Treg equal or less than 0.43 was used as cutoff value,and diagnostic sensitivity and specificity were 81.24%and 88.70%respectively.Treg T lymphocyte ratio more than or equal 32.28%was used as cutoff value,and diagnostic sensitivity and specificity were 84.35%and 87.92%respectively.Conclusion There is an imbalance of immuno inflammatory reaction in children with recurrent respiratory infection.Ratio of Treg T lymphocytes and Th17/Treg ratio have correlation with serum inflammatory factor levels.Ratios of Th1/Th2,Th17/Treg and Treg T lymphocytes in peripheral blood have a certain value in diagnosis of recurrent respiratory infection.
作者
付丽
滕瑞红
柳俊芳
吕思珍
张勇
刘晓丽
刘建军
FU Li;TENG Rui-hong;LIU Jun-fang;LYU Si-zhen;ZHANG Yong;LIU Xiao-li;LIU Jian-jun(Department of Pediatrics,People's Hospital of Huanghua County,Huanghua,Hebei 061100,China;Department of Traditional Chinese Medicine,People's Hospital of Huanghua County,Huanghua,Hebei 061100,China;Department of Pediatrics,People's Hospital of Yanshan County,Yanshan,Hebei 061300,China)
出处
《解放军医药杂志》
CAS
2019年第12期69-72,80,共5页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
河北省中医药管理局科研计划项目(2019280)
河北省卫生厅科研基金项目(20191716)
