外周血CXCL10及其受体CXCR3在复发性生殖器疱疹病毒2型感染患者中表达及其与预后关系研究

Expression of Peripheral Blood CXCL10 and Its Receptor CXCR3 in Patients with Recurrent Genital Herpes Virus Type 2 Infection and Its Relationship with Prognosis

目的探讨外周血CXC趋化因子配体10(CXCL10)及其CXC趋化因子受体3(CXCR3)在复发性生殖器疱疹病毒2型感染患者中的表达及其与预后的关系。方法选取2019年7月—2020年7月医院收治的102例复发性生殖器疱疹病毒2型感染患者,另选取同期来院体检的94例健康者,比较复发性生殖器疱疹病毒2型感染患者与健康体检者外周血CXCL10和CXCR3水平。根据临床分期,将102例复发性生殖器疱疹病毒2型感染患者分为发作期(44例)和稳定期(58例),比较发作期和稳定期患者外周血CXCL10和CXCR3水平。随访1年,统计患者复发情况,采用单因素分析影响复发性生殖器疱疹病毒2型感染患者频繁复发的因素,并对其因素进行Logistic回归分析,采用受试者工作特征曲线(ROC)分析外周血CXCL10和CXCR3水平预测复发性生殖器疱疹病毒2型感染患者频繁复发的价值。结果复发性生殖器疱疹病毒2型感染患者外周血CXCL10和CXCR3水平低于健康体检者(P<0.05);发作期患者外周血CXCL10和CXCR3水平低于稳定期患者(P<0.05);随访1年,102例复发性生殖器疱疹病毒2型感染患者中共有28例频繁复发,频繁复发患者性伙伴个数3个及以上构成比高于非频繁复发患者(P<0.05),频繁复发患者外周血干扰素-γ(IFN-γ)、CXCL10和CXCR3水平均低于非频繁复发患者(P<0.05);Logistic多因素回归分析显示性伙伴个数、CXCR3和CXCL10均是影响复发性生殖器疱疹病毒2型感染患者频繁复发的独立危险因素(P<0.05);ROC分析显示,外周血CXCL10和CXCR3预测复发性生殖器疱疹病毒2型感染患者频繁复发的最佳截断点分别为10.14 pg/mL和8.20 ng/mL,曲线下面积(AUC)分别为0.806和0.822,二者联合的特异度和AUC分别为91.89%和0.914。结论复发性生殖器疱疹病毒2型感染患者CXCL10和CXCR3水平均异常降低,二者均与患者频繁复发密切相关,可作为临床预测复发性生殖器疱疹病毒2型感染患者频繁复发的敏感指标。

Objective In order to explore the expression of peripheral blood CXC chemokine ligand 10(CXCL10)and CXC chemokine receptor 3(CXCR3)in patients with recurrent genital herpes virus type 2 infection and its relationship with prognosis.Methods Totally 102 patients with recurrent genital herpes virus type 2 infection who were admitted to the hospital from July 2019 to July 2020 were selected,and 94 healthy people who came to the hospital for physical examination during the same period were selected.The levels of CXCL10 and CXCR3 in peripheral blood of patients with recurrent genital herpes virus type 2 infection and healthy subjects were compared.According to clinical stage,102 patients with recurrent genital herpes virus type 2 infection were divided into breakout stage(44 cases)and stable stage(58 cases),the levels of CXCL10 and CXCR3 in peripheral blood of patients in the breakout and stable stages were compared.The patients were followed up for one year,and the recurrence rate of the patients was counted,univariate analysis was used to analyze the factors affecting the frequent recurrence of patients with recurrent genital herpes virus type 2 infection,and logistic regression analysis was performed on the factors,receiver operating curve(ROC)was used to analyze the value of peripheral blood CXCL10 and CXCR3 levels in predicting frequent relapse in patients with recurrent genital herpes virus type 2 infection.Results The level of CXCL10,CXCR3 in peripheral blood of patients with recurrent genital herpes virus type 2 infection were lower than that of healthy subjects(P<0.05).The levels of CXCL10,CXCR3 in peripheral blood of patients in breakout stage were lower than those in patients in stable stage(P<0.05).During one year follow-up,28 cases of the 102 patients with recurrent genital herpes virus type 2 infection had frequent recurrence,the composition ratio of the number of sexual partners of three or more in patients with frequent recurrence was higher than those in patients with infrequent recurrence(P<0.05).The levels of peripheral blood interferon-γ(IFN-γ),CXCL10 and CXCR3 in patients with frequent recurrence were lower than those in patients with infrequent recurrence(P<0.05).Logistic multivariate regression analysis showed that the number of sexual partners,CXCR3 and CXCL10 were independent risk factors for frequent recurrence in patients with recurrent genital herpes virus type 2 infection(P<0.05).The ROC analysis showed that the optimal cut-off points of CXCL10 and CXCR3 in peripheral blood for predicting frequent recurrence in patients with recurrent genital herpes virus type 2 infection were 10.14 pg/mL and 8.20 ng/mL;and the areas under the curve(AUC)were 0.806 and 0.822,the combined specificity and AUC of the two were 91.89%and 0.914,respectively.Conclusion The levels of CXCL10 and CXCR3 in patients with recurrent genital herpes virus type 2 infection are abnormally reduced,both of which are closely related to frequent recurrence of patients,and they can be used as sensitive indicators for clinical prediction of frequent recurrence of patients with recurrent genital herpes virus type 2 infection.