自身免疫性肝炎患者外周血OX40/OX40L变化及临床意义

Changes of OX40/OX40L in peripheral blood of patients with autoimmune hepatitis and its clinical significance

目的探讨自身免疫性肝炎(AIH)患者外周血OX40/OX40L变化及临床意义。方法选取2019年7月至2020年12月绵阳市中心医院收治的85例AIH患者(研究组)及同时间段体检的62例健康人群(对照组)为研究对象。对比两组临床特征及外周血OX40/OX40L阳性表达率,分析影响AIH发生的因素,以受试者工作特征(ROC)曲线下面积(AUC)评估OX40/OX40L预测AIH发生的诊断价值。结果两组T淋巴细胞亚群、C反应蛋白、白细胞计数、白细胞介素-6、白细胞介素-4、白细胞介素-21、趋化因子、谷丙转氨酶水平对比差异具有统计学意义(P<0.05);研究组外周血OX40/OX40L阳性表达率分别为(12.43±2.13)%、(14.91±2.18)%,对照组分别为(6.59±1.16)%、(4.82±0.73)%,差异具有统计学意义(P<0.05)。Logistic多因素分析显示白细胞介素-21、OX40/OX40L水平是AIH发生的影响因素(95%CI分别为1.517~6.073、4.903~8.418、0.844~0.985,P均<0.05)。ROC曲线分析显示OX40/OX40L及二者联合诊断AIH的AUC分别为0.804(95%CI:0.699~0.909)、0.789(95%CI:0.682~0.895)、0.914(95%CI:0.844~0.985)。结论AIH患者外周血OX40/OX40L过度表达,OX40、OX40L联合诊断AIH具有较高价值。

Objective To explore the changes and clinical significance of OX40/OX40L in peripheral blood of patients with autoimmune hepatitis(AIH).Methods The 85 AIH patients admitted to the hospital from July 2019 to December 2020(research group)and 62 healthy people(control group)undergoing physical examination at the same time period were selected as the research objects.The clinical characteristics and the positive expression rate of OX40/OX40L in peripheral blood were compared between the two groups,and the factors affecting the occurrence of AIH were analyzed.The area under the receiver operating characteristic(ROC)curve(AUC)was used to evaluate the diagnostic value of OX40/OX40L in predicting the occurrence of AIH.Results The two groups of T lymphocyte subsets,C-reactive protein,white blood cell count,interleukin-6,interleukin-4,interleukin-21,chemokine,and alanine aminotransferase levels were statistically significant(P<0.05).The positive expression rates of OX40/OX40L in the peripheral blood of the study group were(12.43±2.13)%and(14.91±2.18)%,respectively,and the control group were(6.59±1.16)%and(4.82±0.73)%,respectively.The difference was statistically significant(P<0.05).Logistic multivariate analysis showed that the levels of interleukin-21 and OX40/OX40L were the influencing factors of AIH(95%CI were 1.517~6.073,4.903~8.418,0.844~0.985,all P<0.05).ROC curve analysis showed that the AUC of OX40/OX40L and the combination of the two in the diagnosis of AIH were 0.804(95%CI:0.699~0.909),0.789(95%CI:0.682~0.895),0.914(95%CI:0.844~0.985).Conclusion OX40/OX40L is overexpressed in the peripheral blood of patients with AIH,and the combination of OX40 and OX40L has high value in the diagnosis of AIH.