艾滋病患者FOXP3、CXCR5、TGF-β1和T淋巴细胞亚群及其对预后的预测价值

FOXP3,CXCR5,TGF-β1 and T lymphocyte subsets in AIDS patients and their predictive value for prognostic

目的 探究艾滋病患者血清叉头状转录因子P3(FOXP3)、趋化因子CXC受体5(CXCR5)、转化生长因子-β1(TGF-β1)和T淋巴细胞亚群及其对预后的预测价值.方法 选取乐清市人民医院2021年11月-2022年11月诊治的207例艾滋病患者作为研究组,选取同期于医院体检的健康体检者217名作为对照组;研究组随访6个月后存活且病情好转的患者设为良好预后组(n=116),死亡或病情加重的患者设为不良预后组(n=91);比较两组研究对象血清 FOXP3、CXCR5、TGF-β1、CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+);采用 Pearson 相关性分析血清 FOXP3、CXCR5、TGF-β1与T淋巴细胞亚群的相关性;比较不同预后艾滋病患者FOXP3、CXCR5、TGF-β1;采用受试者工作特征(ROC)曲线分析血清FOXP3、CXCR5、TGF-β1对艾滋病患者不良预后的诊断价值.结果 研究组FOXP3、CXCR5、CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+)低于对照组(P<0.05),TGF-β1 水平高于对照组(P<0.05);艾滋病患者 FOXP3、CXCR5 与 CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+)水平呈正相关(P<0.05),TGF-β1 与 CD_(4)^(+)、CD_(8)^(+)呈负相关(P<0.05),与CD_(4)^(+)/CD_(8)^(+)呈正相关(P<0.05);不良预后组FOXP3、CXCR5低于良好预后组(P<0.05),TGF-β1高于良好预后组(P<0.05);FOXP3、CXCR5、TGF-β1联合检测诊断艾滋病患者不良预后的曲线下面积(AUC)高于FOXP3、CXCR5、TGF-β1单一检测(P<0.05),且联合检测的敏感度为87.91%,特异度为85.34%.结论 艾滋病患者FOXP3、CXCR5、CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+)呈低表达,TGF-β1呈高表达,且血清FOXP3、CX-CR5、TGF-β1与T淋巴细胞亚群均有相关性;血清FOXP3、CXCR5、TGF-β1三者联合检测可提高艾滋病患者不良预后的诊断价值.

OBJECTIVE To investigate serum forkhead transcription factor P3(FOXP3),chemokine CXC receptor 5(CXCR5),transforming growth factor-β1(TGF-β1)and T lymphocyte subsets in AIDS patients and its predictive value for prognosis.METHODS Totally 207 AIDS patients diagnosed and treated in Yueqing People's Hospital from Nov.2021 to Nov.2022 were retrospectively selected as the study group,and 217 healthy people underwent healthy examination in Yueqing People's Hospital during the same period were selected as the control group.In the study group,patients who survived and improved after 6 months of follow-up were set as the good prognosis group(n=116),and patients who died or got worse were assigned to the poor prognosis group(n=91).Serum FOXP3,CXCR5,TGF-β1,CD_(4)^(+),CD_(8)^(+),CD_(4)^(+)/CD_(8)^(+)were compared between the two groups.The correlation between serum FOXP3,CXCR5,TGF-βl and T lymphocyte subsets was analyzed by Pearson correlation.FOXP3,CXCR5 and TGF-β1 were compared in AIDS patients with different prognosis.Receiver operating characteristic curve(ROC)was used to analyze the diagnostic value of serum FOXP3,CXCR5 and TGF-β1 for poor prognosis in AIDS patients.RESULTS The serum levels of FOXP3,CXCR5,CD_(4)^(+),CD_(8)^(+),CD_(4)^(+)/CD_(8)^(+)in the study group were lower than those in the control group(P<0.05),while the levels of TGF-βl were higher than those in the control group(P<0.05).In AIDS patients,FOXP3,CXCR5 were positively correlated with CD_(4)^(+),CD_(8)^(+),CD_(4)^(+)/CD_(8)^(+) levels(P<0.05),TGF-β1 was negatively correlated with CD_(4)^(+),CD_(8)^(+),and positively correlated with CD_(4)^(+)/CD_(8)^(+)(P<0.05).FOXP3 and CXCR5 in the poor prognosis group were lower than those in the good prognosis group(P<0.05),and TGF-βl were higher than those in the good prognosis group(P<0.05).The area under the curve(AUC)of the combined detection of FOXP3,CXCR5 and TGF-β1 in the diagnosis of poor prognosis of AIDS patients was higher than that of FOXP3,CXCR5 and TGF-β1 alone(P<0.05),and the sensitivity and specificity of the combined detection were 87.91%and 85.34%,respectively.CONCLUSION The expression of FOXP3,CXCR5,CD_(4)^(+),CD_(8)^(+),CD_(4)^(+)/CD_(8)^(+)of AIDS patients were decreased,and the expression of TGF-β1 was increased,and the serum FOXP3,CXCR5 and TGF-β1 were correlated with T lymphocyte subsets.The combined detection of serum FOXP3,CXCR5 and TGF-β1 could improve the diagnostic value of poor prognosis in AIDS patients.