慢性血吸虫病患者血清NF-κB和T淋巴细胞亚群水平及临床意义

The levels and clinical significance of serum NF-κB and T lymphocyte subsets in patients with chronic schistosomiasis

目的探讨慢性血吸虫病患者血清核转录因子κB(NF⁃κB)、T淋巴细胞亚群水平及临床意义。方法选取2016年1月-2019年12月武汉市第七医院60例慢性血吸虫病患者作为血吸虫病组,另选取30名健康体检群体作为对照组,所有研究对象均检测外周血T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))以及血清NF⁃κB水平,比较两组血液指标差异,并依照血吸虫病患者肝纤维化程度,分析患者肝纤维化程度与血液指标的关系。结果血吸虫病组患者血清NF⁃κB水平以及外周血CD8^(+)水平高于对照组[(47.81±8.41)ng/mL vs.(20.25±5.33)ng/mL、(32.94±5.33)%vs.(27.29±4.39)%],外周血CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平低于对照组[(62.15±9.71)%vs.(74.73±11.83)%、(38.01±4.63)%vs.(42.66±5.16)%、(1.16±0.19)vs.(1.56±0.24)],差异均有统计学意义(P<0.05);血清NF⁃κB及外周血CD3^(+)、CD4^(+)/CD8^(+)在血吸虫病评估中ROC曲线下面积分别为0.882、0.829、0.898(P<0.05);血吸虫病Ⅲ级肝纤维化患者NF⁃κB水平高于0级与Ⅰ~Ⅱ级,Ⅰ~Ⅱ级高于0级,差异均有统计学意义(P<0.05);Ⅲ级肝纤维化患者CD3^(+)、CD4^(+)/CD8^(+)水平低于0级与Ⅰ~Ⅱ级,Ⅰ~Ⅱ级低于0级,差异均有统计学意义(P<0.05);Spearman相关性分析结果显示血吸虫病患者肝纤维化程度与血清NF⁃κB水平呈现正相关(r=0.394,P<0.05);肝纤维化程度与外周血CD3^(+)、CD4^(+)/CD8^(+)水平呈负相关(r=-0.328、-0.430,P<0.05)。结论慢性血吸虫病患者血清NF⁃κB及外周血T淋巴细胞亚群CD8^(+)呈现高表达,CD3^(+)、CD4^(+)呈现低表达,且其表达水平与患者肝纤维化程度相关。

Objective To explore the levels and clinical significance of serum nuclear factor⁃kappa B(NF⁃κB)and T lymphocyte subsets in patients with chronic schistosomiasis.Methods A total of 60 patients with schistosomiasis in the hospital were enrolled as schistosomiasis group between January 2016 and December 2019,while other 30 healthy controls were enrolled as control group.All objects were tested for levels of peripheral blood T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+))and serum NF⁃κB.The differences in blood indexes between the two groups were compared.The relationship between liver fibrosis and blood indexes in schistosomiasis patients was analyzed.Results The level of serum NF⁃κB and peripheral blood CD8^(+)in schistosomiasis group were higher than those in control group[(47.81±8.41)ng/mL vs.(20.25±5.33)ng/mL,(32.94±5.33)%vs.(27.29±4.39)%],while levels of peripheral blood CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)were lower than those in control group[(62.15±9.71)%vs.(74.73±11.83)%,(38.01±4.63)%vs.(42.66±5.16)%,(1.16±0.19)vs.(1.56±0.24)];the differences were statistically significant(P<0.05).The area under the ROC curve(AUC)values of serum NF⁃κB,peripheral blood CD3^(+)and CD4^(+)/CD8^(+)in the assessment of schistosomiasis were 0.882,0.829 and 0.898,respectively(P<0.05).The level of NF⁃κB was the highest in schistosomiasis patients with liver fibrosis at gradeⅢ,followed by gradeⅠ⁃Ⅱand grade 0(P<0.05),while levels of CD3^(+)and CD4^(+)/CD8^(+)were on the contrary(P<0.05).The results of Spearman correlation analysis showed that degree of liver fibrosis was positively correlated with serum NF⁃κB level(r=0.394,P<0.05),while negatively correlated with peripheral blood CD3^(+)and CD4^(+)/CD8^(+)(r=-0.328,-0.430,P<0.05).Conclusions The levels of serum NF⁃κB and peripheral blood CD8^(+)were high,while levels of CD3^(+)and CD4^(+)were low in patients with chronic schistosomiasis.And their expression levels were correlated with the degree of liver fibrosis.