AD患者Th17细胞及其细胞因子水平的变化及其临床意义

Changes of Th17 cell and cytokine levels in AD patients and its clinical significance

目的观察特应性皮炎(AD)患者Th17细胞及其细胞因子水平,分析Th17细胞及其细胞因子水平与患者疾病程度的相关性。方法回顾性分析2015年3月至2016年8月在该院接受治疗的符合纳入及排除标准的65例AD患者(AD组)的临床资料,根据SCORAD评分将其分为轻度(20例)、中度(28例)和重度(17例);同时选取同期在该院体检的健康成年人60例作为对照组。观察AD组和对照组、不同疾病程度AD患者Th17细胞及其细胞因子水平的差异,分析AD患者SCORAD评分和Th17细胞及其细胞因子水平的相关性。结果 AD组患者白细胞介素(IL)-4、IL-10、IL-17、IL-23水平高于对照组(P<0.01),AD组患者γ-干扰素(INF-γ)、IL-21和转化生长因子-β(TGF-β)水平与对照组相比差异无统计学意义(P>0.05);不同疾病程度AD患者的IL-4、IL-10、IL-17、IL-23水平均依次为重度组>中度组>轻度组,差异有统计学意义(P<0.05),重度组、中度组、轻度组3组患者的INF-γ、IL-21和TGF-β水平差异无统计学意义(P>0.05);AD患者的SCORAD评分与IL-4、IL-10、IL-17、IL-23水平呈正相关,与INF-γ、IL-21和TGF-β水平无明显相关关系。结论 AD患者的IL-4、IL-10、IL-17、IL-23水平较高,而INF-γ、IL-21和TGF-β水平与健康者无差别,且患者的细胞因子水平与患者的瘙痒程度密切相关。

Objective To investigate the levels of Th17 cells and cytokines in patients with atopic dermatitis(AD),and to analyze the correlation between the level of Th17 cells and their cytokines and the degree of itching.Methods The clinical data of AD patients treated in our hospital from March 2015 to August 2016 were retrospectively analyzed.At the same time,the healthy adults in our hospital were selected as the control group.To observe the difference of AD cell and cytokine levels in Th17 and control group,AD patients with different degrees of pruritus,and to analyze the correlation between pruritus score and Th17 cell and cytokine levels in patients with AD.Results The patients in the AD group of IL-4,IL-10,IL-17,IL-23 levels higher than the control group(P<0.01),there was no significant difference in INF-γ,IL-21 and TGF-βlevel(P>0.05).There are significant differences between the levels of cytokines in different disease severity in patients with AD,three patients with IL-4,IL-10,IL-17 and IL-23 levels from high to low are severe,moderate and mild group,no difference between the three groups of patients with INF-γ,IL-21 and TGF-βlevels.The SCORAD score of D patients was positively correlated with the levels of IL-4,IL-10,IL-17 and IL-23,and there was no significant correlation between the levels of INF-γ,IL-21 and TGF-β.Conclusion The levels of IL-4,IL-10,IL-17 and IL-23 were higher in patients with atopic dermatitis,but the levels of INF-γ,IL-21 and TGF-βwere not different from those of normal controls,and the level of cytokines in patients was closely related to the degree of itching.