哮喘患者Th1/Th2细胞因子水平变化及其临床意义

Clinical significance of Th1/Th2 cytokines levels in asthma patients

目的探讨哮喘患者Th1/Th2细胞因子水平变化及其临床检测价值。方法选取2017年5月-2020年5月河南省人民医院152例哮喘患者纳入哮喘组,其中急性发作期80例,缓解期72例,将急性发作期患者依照疾病严重程度分为轻度组(n=29)、中度组(n=27)、重度组(n=24)三个亚组;另选取60名健康体检者作为对照组。比较各组外周血中Th1细胞及Th2细胞的含量,并计算Th1/Th2值,分析哮喘患者外周血Th1/Th2水平变化及其对疾病严重程度的评估价值。结果哮喘组外周血Th1、Th1/Th2水平低于对照组,Th2水平高于对照组,差异有统计学意义(P均<0.05)。哮喘组急性发作期患者外周血Th1、Th1/Th2水平低于缓解期患者,Th2水平高于缓解期患者,差异均有统计学意义(P均<0.05)。急性发作期患者中轻度组外周血Th1、Th1/Th2水平高于中度组,中度组高于重度组;Th2水平低于中度组,中度组低于重度组(P均<0.05)。Th1/Th2评估轻度与中度急性发作期哮喘ROC曲线下面积为0.866,均大于Th1、Th2评估曲线下面积(分别为0.746、0.711)(P<0.05);Th1/Th2评估中度与重度急性发作期哮喘ROC曲线下面积为0.842,均大于Th1、Th2评估曲线下面积(分别为0.734、0.731)(P<0.05)。Spearman相关分析结果显示,血清Th1/Th2与急性发作期哮喘严重程度成负相关(r=-0.601,P<0.05)。结论哮喘患者外周血Th1/Th2水平降低,且疾病急性发作期低于缓解期,Th1/Th2失衡与患者疾病急性发作期严重程度密切相关,其水平可有效评估患者病情。

Objective To explore the changes and clinical value of Th1/Th2 cytokines levels in asthma patients.Methods A total of 152 asthma patients in the hospital from May 2017 to May 2020 were enrolled as asthma group,including 80cases in acute attack stage and 72 cases in remission stage.The 80 patients in acute attack stage were divided into mild group(n=29),moderate group(n=27)and severe group(n=24)according to disease severity.Another 60 healthy controls were enrolled as control group.The contents of peripheral blood Th1 cells and Th2 cells in all groups were detected and compared.And Th1/Th2 was calculated.The changes in peripheral blood Th1/Th2 cytokines level in asthma patients were analyzed.And its evaluation value for disease severity was analyzed.Results The levels of peripheral blood Th1 and Th1/Th2 cytokines in asthma group were lower than those in control group,while Th2 cytokines level was higher than that in control group(P<0.05).In asthma group,levels of peripheral blood Th1 cytokines and Th1/Th2 cytokines in patients during acute attack stage were lower than those during remission stage,while Th2 cytokines level was higher than that during remission stage(P<0.05).The levels of peripheral blood Th1 cytokines and Th1/Th2 cytokines in mild group were higher than those in moderate group,which were higher in moderate group than severe group.Th2 cytokines level in mild group was lower than that in moderate group,which was lower in moderate group than severe group(P<0.05).The area under the ROC curve(AUC)of Th1/Th2 in the evaluation of mild and moderate asthma in acute attack stage was 0.866,greater than that of Th1 and Th2(0.746,0.711)(P<0.05).AUC of Th1/Th2 in the evaluation of moderate and severe asthma in acute attack stage was 0.842,greater than that of Th1 and Th2(0.734,0.731)(P<0.05).The results of Spearman correlation analysis showed that serum Th1/Th2 cytokines was negatively correlated with the severity of asthma in acute attack stage(r=-0.601,P<0.05).Conclusion s The level of peripheral blood Th1/Th2 cytokines decreases in asthma patients,and the severity of asthma in acute attack stage was milder than that in remission stage.Th1/Th2 imbalance was closely related to the severity of asthma in acute attack stage,and its level could effectively assess the conditions of patients.