子宫内膜异位症合并下生殖道感染患者外周血Th17/Treg和血清细胞因子变化

Research on the variation levels of Th17/Treg and serum cytokines in peripheral blood in patients with endometriosis and lower genital tract infection

目的探究子宫内膜异位症合并下生殖道感染患者外周血辅助性T细胞/调节性T细胞(Helper T cell/regulatory T cell,Th17/Treg)和血清细胞因子水平改变及其价值。方法选择武汉市中心医院妇科2017年8月-2019年10月收治的子宫内膜异位症合并下生殖道感染患者40例纳入研究组,另随机选择同期收治的子宫内膜异位症未合并感染的患者45例纳入对照组。采用流式细胞术检测两组研究对象外周血Th17、Treg、Th17/Treg水平,采用酶联免疫吸附法对血清中白细胞介素-10(IL-10)、白细胞介素-17(IL-17)、白细胞介素-22(IL-22)水平进行检测。结果研究组患者40份宫颈、阴道分泌物标本共检出病原菌32株,其中革兰阳性菌占40.63%,革兰阴性菌占46.87%,真菌占12.50%;研究组患者外周血Th17、Th17/Treg、IL-17、IL-22水平高于对照组,Treg、IL-10水平低于对照组,差异均具有统计学意义(P<0.05)。结论子宫内膜异位症合并下生殖道感染患者Th17/Treg免疫失衡更为严重,可能是导致疾病加重的重要原因。

OBJECTIVE To explore the changes and clinical value of peripheral blood helper T cells/regulatory T cells(Th17/Treg) and serum cytokine levels in patients with endometriosis and lower genital tract infection. METHODS Forty patients with endometriosis combined with lower genital tract infection, who were admitted to the Department of Gynecology of Wuhan Central Hospital from Aug. 2017 to Oct. 2019 were enrolled in the study group;45 patients with endometriosis without lower genital tract infection were included in the control group. Flow cytometry was used to detect the levels of Th17, Treg, Th17/Treg in the peripheral blood of the two groups of subjects. Enzyme-linked immunosorbent assay(ELISA) was used to detect the levels of interleukin-10(IL-10), interleukin-17(IL-17) and interleukin-22(IL-22) in serum. RESULTS A total of 32 pathogenic bacteria strains were detected in 40 cervical and vaginal secretion specimens of patients of the study group, of which 40.63% were Gram-positive bacteria, 46.87% were Gram-negative bacteria, and 12.50% were fungi. Th17, Th17/Treg, IL-17 and IL-22 levels in the peripheral blood in the study group were higher than that in the control group. Treg and IL-10 levels were significantly lower than that in the control group(P<0.05). CONCLUSION The imbalance of Th17/Treg immune in patients with endometriosis and lower genital tract infection was more serious, which may be an important cause of the disease.