重症肌无力患者血清PD-1、TLR4、IL-23水平与病情严重程度相关性及其预测效能分析

Correlation between serum PD-1,TLR4,IL-23 levels and severity of myasthenia gravis

目的 探究重症肌无力(MG)患者血清程序性死亡受体1(PD-1)、Toll样受体4(TLR4)、白细胞介素-23(IL-23)水平与病情严重程度相关性及其预测效能。方法 选取2019年1月到2021年1月我院收治的91例MG患者作为MG组,另选91例体检健康人员作为对照组,比较两组血清PD-1、TLR4、IL-23水平,并分析其与MG病情严重程度关系及对MG患者发生危象的预测价值。结果 MG组血清PD-1、TLR4、IL-23水平高于对照组,且随MG病情严重程度增加,PD-1、TLR4、IL-23水平逐渐升高(P<0.05);Spearman相关性分析显示,血清PD-1、TLR4、IL-23水平与MG患者病情严重程度呈正相关(r=0.741、0.844、0.785,P<0.001);发生危象患者血清PD-1、TLR4、IL-23水平高于无危象患者(P<0.05);血清PD-1、TLR4、IL-23预测MG患者发生危象的AUC分别为0.799、0.739、0.722,三者联合检测的AUC为0.873,高于单一检测指标(P<0.05)。结论 MG患者血清PD-1、TLR4、IL-23水平明显上调,且与病情严重程度呈正相关,对预测MG预后具有一定的临床价值。

Objective To explore the correlation between the serum levels of programmed death receptor-1(PD-1),toll like receptor 4(TLR4)and interleukin-23(IL-23)and the severity of myasthenia gravis(mg)and their predictive efficacy.Methods 91 MG patients from January 2019 to January 2021 were selected as mg group, and 91 healthy persons were selected as control group.The levels of serum PD-1,TLR4 and IL-23 were compared between the two groups, and the relationship between them and the severity of Mg and the predictive value of Mg crisis were analyzed.Results The serum levels of PD-1,TLR4 and IL-23 in mg group were higher than those in control group, and the levels of PD-1,TLR4 and IL-23 gradually increased with the severity of Mg(P<0.05);Spearman correlation analysis showed that the serum levels of PD-1,TLR4 and IL-23 were positively correlated with the severity of Mg(r=0.741,0.844,0.785,P<0.001);The levels of PD-1,TLR4 and IL-23 in patients with crisis were higher than those in patients without crisis(P<0.05);The AUC of PD-1,TLR4 and IL-23 in predicting crisis in MG patients were 0.799,0.739 and 0.722 respectively, and the AUC of combined detection of the three was 0.873,which was higher than that of single detection index(P<0.05).Conclusion The serum levels of PD-1,TLR4 and IL-23 are significantly up-regulated in patients with Mg, and positively correlated with the severity of Mg, which has a certain clinical value in predicting the prognosis of Mg.