唇炎患者血清淋巴细胞亚群、免疫球蛋白和补体水平的变化特征研究

Study on the variation characteristics of serum lymphocyte subsets,immunoglobulins,and complement levels in patients with cheilitis

目的分析唇炎患者血清淋巴细胞亚群、免疫球蛋白及补体水平变化特征,探讨唇炎患者血清免疫水平的变化与唇炎发病间的关联。方法回顾性选择2017年1月至2023年12月于郑州大学第一附属医院口腔科就诊的153例唇炎患者(唇炎组),与同期于医院体检科就诊的50例健康体检者(对照组)进行对比,分析唇炎患者血清淋巴细胞亚群、免疫球蛋白及补体水平变化特征。主要检测指标包括总T淋巴细胞百分比(T%)、辅助/诱导T淋巴细胞百分比(CD4^(+)T%)、总T淋巴细胞绝对数目(T#)、辅助/诱导T淋巴细胞绝对数目(CD4^(+)T#)、自然杀伤细胞百分比(NK%)、B淋巴细胞绝对数目(B#),免疫球蛋白IgG、IgM,补体C3、C4。采用多元Logistic回归探索血清淋巴细胞亚群、免疫球蛋白及补体水平与唇炎的关系。再将唇炎患者按不同性别、年龄、唇炎类型、严重程度分类进行亚组分析。结果唇炎组T%[69.54%(64.41%,75.14%)]、CD4^(+)T%[(35.09±7.10)%]、T#[1328.00(1054.00,1560.50)个]、CD4^(+)T#[653.00(505.00,831.50)个]水平均显著低于对照组[分别为72.33%(69.41%,75.47%)、(39.07±5.84)%、1483.50(1245.75,1805.25)个和769.00(687.25,933.00)个](Z=-2.64,P=0.008;t=3.58,P<0.001;Z=-2.80,P=0.005;Z=-3.80,P<0.001),NK%[16.21%(12.16%,21.29%)]水平显著高于对照组[14.61%(10.97%,17.87%)](Z=-2.28,P=0.023),IgG[12.29(10.77,13.73)g/L]、IgM水平[1.18(0.86,1.58)g/L]均显著高于对照组[分别为11.52(10.16,12.91)g/L、0.99(0.77,1.26)g/L](Z=-2.24,P=0.025;Z=-2.10,P=0.036),补体C3[(1.09±0.17)g/L]、C4水平[0.23(0.19,0.28)g/L]均显著低于对照组[分别为(1.18±0.17)g/L、0.31(0.24,0.35)g/L](t=3.10,P=0.002;Z=-4.79,P<0.001)。Logistic回归显示,IgG升高(P=0.021)、C4降低(P<0.001)、CD4^(+)T%降低(P=0.003)、T#降低(P=0.035)均为唇炎发生的独立影响因素。唇炎组淋巴细胞免疫分析异常率[68.0%(104/153)]显著高于对照组[24.0%(12/50)](χ^(2)=29.76,P<0.001)。唇炎组免疫球蛋白及补体检测异常率[41.8%(64/153)]显著高于对照组[4.0%(2/50)](χ^(2)=24.58,P<0.001)。女性唇炎患者免疫球蛋白及补体检测异常率[51.5%(53/103)]显著高于男性[22.0%(11/50)](χ^(2)=12.00,P=0.001)。肉芽肿性唇炎组患者T#[1136.50(663.75,1310.50)个]、B#水平[162.50(104.00,225.50)个]均显著低于慢性唇炎组[分别为1366.00(1063.03,1602.00)个、202.48(148.00,298.00)个](Z=-2.35,P=0.019;Z=-2.16,P=0.031)。结论唇炎患者细胞免疫、体液免疫和固有免疫均存在一定程度的失衡,这种失衡可能与唇炎发病相关。

Objective:To analyze the variations of serum lymphocyte subsets,immunoglobulins,and complement levels in patients with cheilitis,and to explore the associations between the changes in serum immune levels and the onset of cheilitis.Methods:A retrospective analysis was conducted on 153 patients with cheilitis who visited the Department of Stomatology,The First Affiliated Hospital of Zhengzhou University from January 2017 to December 2023.They were compared with 50 healthy individuals who visited the physical examination department during the same period.The changes of serum lymphocyte subsets,immunoglobulins,and complement levels in patients with cheilitis were analyzed.Main detection indicators as the percentage of total T lymphocytes(T%),helper/inducer T lymphocytes(CD4^(+)T%),absolute numbers of total T lymphocytes(T#),absolute numbers of helper/inducer T lymphocytes(CD4^(+)T#),percentage of natural killer cells(NK%),absolute numbers of B lymphocytes(B#),immunoglobulins IgG,IgM and complement C3,C4 were included.Multivariate logistic regression was used to explore the relationship between serum lymphocyte subsets,immunoglobulins,complement levels and cheilitis.Subgroup analysis was further conducted on patients with cheilitis based on gender,age,cheilitis type and severity.Results:The levels of T%[69.54%(64.41%,75.14%)],CD4^(+)T%[(35.09±7.10)%],T#[1328.00(1054.00,1560.50)],and CD4^(+)T#[653.00(505.00,831.50)]in the cheilitis group were significantly lower than those in the control group respectively[72.33%(69.41%,75.47%),(39.07±5.84)%,1483.50(1245.75,1805.25),769.00(687.25,933.00),with the corresponding statistical test results of Z=-2.64,P=0.008;t=3.58,P<0.001;Z=-2.80,P=0.005;Z=-3.80,P<0.001].The level of NK%[16.21%(12.16%,21.29%)]was significantly higher in the cheilitis group compared to the control group[14.61%(10.97%,17.87%)](Z=-2.28,P=0.023).IgG[12.29(10.77,13.73)g/L]and IgM levels[1.18(0.86,1.58)g/L]were significantly higher in the cheilitis group than in the control group respectively[11.52(10.16,12.91)g/L,0.99(0.77,1.26)g/L](Z=-2.24,P=0.025;Z=-2.10,P=0.036),while complement C3[(1.09±0.17)g/L]and C4 levels[0.23(0.19,0.28)g/L]were significantly lower in the cheilitis group compared to the control[(1.18±0.17)g/L,0.31(0.24,0.35)g/L](t=3.10,P=0.002;Z=-4.79,P<0.001).Logistic regression analysis showed that elevated IgG(P=0.021),decreased C4(P<0.001),decreased CD4^(+)T%(P=0.003),and decreased T#(P=0.035)were independent influencing factors for the occurrence of cheilitis.The rate of abnormal lymphocyte immune analysis in the cheilitis group[68.0%(104/153)]was significantly higher than that in the control group[24.0%(12/50)](χ^(2)=29.76,P<0.001).The rate of abnormal immunoglobulin and complement detection in the cheilitis group[41.8%(64/153)]was significantly higher than that in the control group[4.0%(2/50)](χ^(2)=24.58,P<0.001).The rate of detection abnormalities in female patients with cheilitis[51.5%(53/103)]was significantly higher than in male ones[22.0%(11/50)](χ^(2)=12.00,P=0.001).Patients with granulomatous cheilitis had significantly lower levels of T#[1136.50(663.75,1310.50)]and B#[162.50(104.00,225.50)]compared to those with chronic cheilitis[1366.00(1063.03,1602.00),202.48(148.00,298.00)](Z=-2.35,P=0.019;Z=-2.16,P=0.031).Conclusions:Patients with cheilitis exhibit a certain degree of imbalance on cellular immunity,humoral immunity,and innate immunity,which may be related to the onset of cheilitis.