TH1、TH17及其细胞因子与结核性胸膜炎患者治疗效果的相关性分析

Correlation analysis of TH1,TH17 and their cytokines with therapeutic effect in patients with tuberculous pleurisy

目的分析辅助性T淋巴细胞1(TH1)、辅助性T淋巴细胞17(TH17)及其细胞因子与结核性胸膜炎患者治疗效果的相关性。方法选取2019年1月至2022年5月河北省胸科医院收治的108例结核性胸膜炎患者为研究对象,均给予2HRZE/10HRE治疗,根据治疗效果将患者分为有效组(n=78)与无效组(n=30)。比较两组胸腔积液的TH1、TH17、TH1细胞因子[肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)]及TH17细胞因子[白细胞介素17(IL-17)]水平;采用多因素logistics回归分析胸腔积液TH1、TH17、TNF-α、IFN-γ、IL-17与结核性胸膜炎患者治疗效果的关系;绘制ROC曲线分析胸腔积液TH1、TH17、TNF-α、IFN-γ、IL-17水平对结核性胸膜炎患者治疗效果的预测价值。结果无效组胸腔积液的TH1、TH17、TNF-α、IFN-γ、IL-17水平均高于有效组,差异均具有统计学意义(t=6.461、5.688、6.726、5.891、7.148,均P<0.05);多因素logistics回归分析显示,TH1、TH17、TNF-α、IFN-γ、IL-17水平升高均是结核性胸膜炎患者治疗效果的独立危险因素(P<0.05);ROC曲线分析显示,胸腔积液TH1、TH17、TNF-α、IFN-γ、IL-17的ROC曲线下面积分别为0.836、0.793、0.836、0.817、0.856(P<0.05)。结论结核性胸膜炎患者治疗效果可能与胸腔积液TH1、TH17及其细胞因子水平相关。

Objective To analyze the correlation of helper T lymphocyte 1(TH1),helper T lym⁃phocyte 17(TH17)and their cytokines with the therapeutic effect of tuberculous pleurisy.Methods 108 pa⁃tients with tuberculous pleurisy admitted to Hebei Chest Hospital from January 2019 to May 2022 were selected as the study subjects.All patients were treated with 2HRZE/10HRE and were divided into two groups:the effec⁃tive group(n=78)and the ineffective group(n=30)based on treatment outcomes.The levels of TH1,TH17,TH1 cytokines[tumor necrosis factor⁃α(TNF⁃α),interferon⁃γ(IFN⁃γ)],and TH17 cytokines[interleukin17(IL⁃17)]in pleural effusion were compared between the two groups.Multifactor logistics regression was used to analyze the relationship between TH1,TH17,TNF⁃α,IFN⁃γ,IL⁃17 and the therapeutic effect of tubercu⁃lous pleurisy.An ROC curve was drawn to analyze the predictive value of TH1,TH17,TNF⁃α,IFN⁃γand IL⁃17 levels in pleural effusion for patients with tuberculous pleurisy.Results The levels of TH1,TH17,TNF⁃α,IFN⁃γand IL⁃17 in pleural effusion in the ineffective group were higher than those in the effective group,with statistical significance(t=6.461,5.688,6.726,5.891,7.148,P<0.05).Multifactor logistic regression analysis showed that the increase in TH1,TH17,TNF⁃α,IFN⁃γand IL⁃17 levels were independent risk factors for treat⁃ment effect in patients with tuberculous pleuritis(P<0.05).ROC curve analysis showed that the areas under the ROC curve of TH1,TH17,TNF⁃α,IFN⁃γand IL⁃17 in pleural effusion were 0.836,0.793,0.836,0.817 and 0.856,respectively(P<0.05).Conclusion The therapeutic effect of tuberculous pleurisy may be related to TH1,TH17,and their cytokine levels in pleural effusion.