血清Th1/Th2趋化因子CXCL10、CCL22水平与溃疡性结肠炎患者疾病活动度的关系

Relationship between serum Th1/Th2 chemokines CXCL10 and CCL22 levels and disease activity in patients with ulcerative colitis.

目的探讨溃疡性结肠炎(UC)患者血清1型辅助性T细胞(Th1)/2型辅助性T细胞(Th2)趋化因子配体10(CXCL10)、CC类趋化因子22(CCL22)表达水平及其与疾病活动度的关系。方法选择2019年1月至2022年6月河南中医药大学第一附属医院收治的157例UC患者作为UC组,43例同期健康体检者作为对照组。采用UC内镜下严重程度指数(UCEIS)评分评估UC疾病的活动度,采用改良梅奥(Mayo)评分评估UC病情程度。UC组患者根据疾病活动度分为缓解组90例和活动组67例。比较三组受检者的血清CXCL10、CCL22、红细胞沉降率(ESR)、血清C反应蛋白(CRP)、中性粒细胞计数和白蛋白(Alb)。采用Pearson相关性分析法分析上述各项指标与改良Mayo评分、UCEIS评分的相关性,采用受试者工作特征曲线(ROC)分析血清CXCL10、CCL22对UC疾病活动度的预测价值。结果活动组患者的血清CXCL10、CCL22、ESR、CRP、中性粒细胞计数分别为(64.06±11.57)ng/mL、(189.15±36.11)ng/mL、(10.95±1.42)mm/h、(15.74±2.56)mg/L、(9.71±0.93)×10^(9)/L,明显高于缓解组的(49.05±11.75)ng/mL、(149.27±27.17)ng/mL、(7.61±0.89)mm/h、(11.53±1.45)mg/L、(5.67±0.82)×10^(9)/L,缓解组的上述各项指标明显高于对照组的(21.21±6.21)ng/mL、(138.22±23.72)ng/mL、(4.98±0.65)mm/h、(7.76±1.48)mg/L、(3.81±0.75)×10^(9)/L,但活动组患者的Alb为(7.21±1.42)g/L,明显低于缓解组的(9.39±1.38)g/L和对照组的(13.26±2.43)g/L,且缓解组明显低于对照组,差异均有统计学意义(P<0.05);活动组患者的改良Mayo评分、UCEIS评分分别为(7.06±0.88)分、(4.39±0.47)分,明显高于缓解组的(3.58±0.72)分、(2.17±0.36)分,差异均有统计学意义(P<0.05);经Pearson相关性分析结果显示,UC患者CXCL10、CCL22、ESR、CRP、中性粒细胞计数与改良Mayo评分、UCEIS评分均呈正相关(P<0.05),Alb与改良Mayo评分、UCEIS评分均呈负相关(P<0.05);经ROC分析结果显示,血清CXCL10、CCL22及两者联合检测预测UC疾病活动度的曲线下面积(AUC)分别为0.813、0.810和0.888,联合预测较单一指标预测的准确度更高。结论UC患者血清CXCL10、CCL22水平升高程度与疾病活动度情况具有密切的关系,两者联合检测对UC患者疾病活动度情况具有较高的预测价值。

Objective To investigate the expression levels of serum T helper 1(Th1)/Th2 chemokine ligand 10(CXCL10)and CC chemokine ligand 22(CCL22)and their correlation with disease activity in patients with ulcerative colitis(UC).Methods A total of 157 UC patients admitted to the First Affiliated Hospital of Henan University of Chinese Medicine from January 2019 to June 2022 were selected as the UC group,and 43 healthy controls receiving physical examinations in the same period were selected as the control group.Ulcerative Colitis Endoscopic Index of Severity(UCEIS)score was used to evaluate the activity of UC disease,and the modified Mayo score was used to evaluate the severity of UC disease.UC patients were divided into remission group of 90 cases and activity group of 67 cases according to disease activity.Serum CXCL10,CCL22,erythrocyte sedimentation rate(ESR),serum C-reactive protein(CRP),neutrophil count,and albumin(Alb)were compared among the three groups of subjects.Pearson correlation analysis was used to analyze the correlation between CXCL10,CCL22,ESR,CRP,neutrophil count,Alb and modified Mayo score,UCEIS score.Receiver operating characteristic(ROC)curves were used to evaluate the predictive value of serum CXCL10 and CCL22 for UC disease activity.Results The serum levels of CXCL10,CCL22,ESR,CRP,and neutrophil counts in the activity group were(64.06±11.57)ng/mL,(189.15±36.11)ng/mL,(10.95±1.42)mm/h,(15.74±2.56)mg/L,and(9.71±0.93)×10^(9)/L,respectively,significantly higher than(49.05±11.75)ng/mL,(149.27±27.17)ng/mL,(7.61±0.89)mm/h,(11.53±1.45)mg/L,and(5.67±0.82)109/L in the remission group;the levels in the remission group were significantly higher than(21.21±6.21)ng/mL,(138.22±23.72)ng/mL,(4.98±0.65)mm/h,(7.76±1.48)mg/L,(3.81±0.75)×10^(9)/L in the control group;the differences were statistically significant(P<0.05).The Alb of the activity group was(7.21±1.42)g/L,which was significantly lower than(9.39±1.38)g/L of the remission group;and Alb in the remission group was significantly lower than(13.26±2.43)g/L of the control group;the differences were statistically significant(P<0.05).The modified Mayo score and UCEIS score of the activity group were(7.06±0.88)points and(4.39±0.47)points,which were significantly higher than(3.58±0.72)points and(2.17±0.36)points of the remission group(P<0.05).Pearson correlation analysis results showed that CXCL10,CCL22,ESR,CRP,and neutrophil count were positively correlated with modified Mayo score and UCEIS score(P<0.05),while Alb was negatively correlated with modified Mayo score and UCEIS score in UC patients(P<0.05).ROC analysis results showed that the areas under ROC curve(AUC)of serum CXCL10,CCL22,and their combination for predicting UC disease activity were 0.813,0.810,and 0.888,respectively,and the combined detection was more accurate than single indicator.Conclusion The increase of serum CXCL10 and CCL22 levels in UC patients are closely related to the disease activity,and the combined detection of the two has a high predictive value for the disease activity of UC patients.