CD4^(+)效应型记忆性T细胞及NLR与特发性面神经麻痹的相关性研究

Correlation Analysis of CD4^(+)effector Memory T cells and NLR with Idiopathic Facial Paralysis

目的探讨特发性面神经麻痹患者外周血中CD4^(+)记忆性T细胞(CD4^(+)Tm)亚群、中性粒细胞/淋巴细胞(NLR)及血小板/淋巴细胞(PLR)的表达水平,并分析其与特发性面神经麻痹的相关性。方法选取2017年8月~2020年10月徐州医科大学附属医院神经内科住院的53例特发性面神经麻痹患者作为实验组,选择同时期年龄、性别相匹配的50例正常人作为对照组。比较两组的临床资料及外周血CD4^(+)Tm细胞亚群[中央型记忆性T细胞(central memory T cell,T CM)及效应型记忆性T细胞(effector memory T cell,T EM)]表达水平,采用单因素和多因素Logistic回归分析研究特发性面神经麻痹患者的危险因素,进一步结合ROC曲线评估其对特发性面神经麻痹的预测价值。结果与对照组比较,实验组NLR、外周血CD4^(+)T EM细胞表达明显增加,差异均有统计学意义(P=0.000),Logistic回归分析显示NLR、CD4^(+)T EM细胞为特发性面神经麻痹的危险因素(P=0.006,P=0.000)。ROC曲线分析显示CD4^(+)T EM细胞及NLR的曲线下面积分别为0.910(95%CI:0.851~0.969,P=0.000)和0.783(95%CI:0.690~0.875,P=0.000),且CD4^(+)T EM细胞曲线下面积大于NLR(P=0.024)。结论CD4^(+)T EM细胞及NLR对特发性面神经麻痹具有较好的诊断价值,可作为特发性面神经麻痹的早期预警标志物。

Objective To explore the expression levels of CD4^(+)memory T cells(CD4^(+)Tm),neutrophil/lymphocyte(NLR)and platelet/lymphocyte(PLR)in peripheral blood of patients with idiopathic facial paralysis,and to analyze their correlation in idiopathic facial paralysis.Methods Totally fifty-three patients with idiopathic facial palsy who were hospitalized in the Department of Neurology at Affiliated Hospital of Xuzhou Medical University from August 2017 to October 2020 were selected as the study group,and 50 normal people matched in age and gender were selected as the control group.We compared two groups of patients with clinical data and peripheral blood CD4^(+)TM cells[central type memory T cells(T CM),the effect of memory T cells(T EM)]expression level,using univariate Logistic regression analysis and multiariable Logistic regression analysis to study risk factors in patients with idiopathic facial palsy,further combining ROC curve evaluation joint detection for predictive value of idiopathic facial palsy.Results Compared with the control group,NLR and CD4^(+)T EM cells in peripheral blood were significantly increased in the study group,and the difference was statistically significant(P=0.000).Logistic regression analysis showed that NLR and CD4^(+)T EM cells were risk factors for idiopathic facial paralysis(P=0.006,P=0.000).ROC curve analysis showed that the area under the curve of CD4^(+)T EM cells and NLR were 0.910(95%CI:0.851-0.969,P=0.000)and 0.783(95%CI:0.690-0.875,P=0.000).Besides,the area under the CD4^(+)T EM cell curve was larger than that of NLR(P=0.024).Conclusion CD4^(+)T EM cells and NLR have better diagnostic value for idiopathic facial palsy and can be used as an early warning marker.