突发性耳聋患者血清T淋巴细胞亚群和Th1/Th2相关细胞因子水平及其临床意义

Serum levels of T lymphocyte subsets and Th1/Th2-related cytokines in patients with sudden deafness and their clinical significance

目的探讨突发性耳聋患者血清T淋巴细胞亚群和Th1/Th2相关细胞因子水平及其临床意义。方法选取60例突发性耳聋患者作为研究组,60例同期体检健康者作为对照组。检测并比较两组外周血CD3^+、CD4^+、CD8^+T淋巴细胞水平,以及血清白细胞介素(IL)-2、IL-4、IL-10、肿瘤坏死因子α(TNF-α)。分析研究组各细胞因子之间的相关性,并比较不同听力下降程度患者细胞因子水平。结果研究组CD3^+、CD4^+、CD8^+T淋巴细胞水平均低于对照组(均P<0.05),但两组CD4^+/CD8^+比值差异无统计学意义(P>0.05)。研究组患者血清IL-4、IL-10水平低于对照组,IL-2水平高于对照组(均P<0.05),但两组TNF-α水平差异无统计学意义(P>0.05);研究组患者IL-2/IL-4、TNF-α/IL-4比值高于对照组(均P<0.05),两组IL-2/IL-10、TNF-α/IL-10比值差异均无统计学意义(均P>0.05)。突发性耳聋患者血清IL-2、TNF-α水平与IL-4水平无明显相关性(P>0.05),与IL-10水平呈负相关性(均P<0.05)。极重度耳聋患者血清IL-4水平低于重度耳聋患者,IL-10水平低于中度耳聋患者,TNF-α水平高于中度、重度耳聋患者(均P<0.05)。结论突发性耳聋患者外周血T淋巴细胞水平降低,同时存在Th1/Th2失衡。Th1介导的IL-2分泌增加,Th2介导的IL-4、IL-10分泌降低,可能参与疾病的发生、发展。

Objective To investigate the levels of serum T lymphocyte subsets and Th1/Th2-related cytokines in patients with sudden deafness and their clinical significance.Methods Sixty patients with sudden deafness were selected as study group,and 60 healthy check-up individuals simultaneously as the control group.Peripheral blood levels of CD3^+,CD4^+and CD8^+T lymphocytes,as well as serum level of interleukin(IL)-2,IL-4,IL-10 and tumor necrosis factorα(TNF-α),were detected and compared between the two groups.The correlation between cytokines in the study groups was analyzed,and the levels of cytokines were compared between patients with various degrees of hearing loss.Results The study group had lower levels of CD3^+,CD4^+,CD8^+T lymphocytes than the control group(all P<0.05),but there was no statistically significant difference in CD4^+/CD8^+ratio between the two groups(P>0.05).Patients in the study group exhibited lower serum IL-4 and IL-10 levels and higher IL-2 level compared to the control group(all P<0.05),but there was no statistically significant difference in TNF-αlevel between the two groups(P>0.05);IL-2/IL-4 ratio and TNF-α/IL-4 ratio in the study group were higher than those in the control group(all P<0.05),and there were no statistically significant differences in IL-2/IL-10 ratio or TNF-α/IL-10 ratio between the two groups(all P>0.05).As for patients with sudden deafness,serum IL-2 or TNF-αlevel did not significantly correlate with IL-4 level(P>0.05),but negatively correlated with IL-10 level(all P<0.05).Patients with extremely severe deafness experienced lower serum IL-4 level than those with severe deafness,lower IL-10 level than those with moderate deafness,and higher TNF-αlevel than those with moderate or severe deafness(all P<0.05).Conclusion Reduction of peripheral T lymphocytes and Th1/Th2 imbalance occur in patients with sudden deafness.Increased Th1-mediated IL-2 secretion,and decreased Th2-mediated IL-4 or IL-10 secretion may be involved in the occurrence and development of the disease.