奥曲肽联合复合辅酶对化脓性阑尾炎患者Th17/CD4^+ CD25^+ Foxp3^+ Treg失衡影响

Effect of octreotide combined with compound coenzyme on Th17/CD4^+ CD25^+ Foxp3^+ Treg imbalance in patients with purulent appendicitis

目的探讨奥曲肽联合复合辅酶对化脓性阑尾炎患者辅助性T细胞17/CD4+CD25+Foxp3+调节性T细胞(Th17/CD4+CD25+Foxp3+Treg)失衡的影响。方法选取宁夏回族自治区人民医院已确诊为急性化脓性阑尾炎患者150例,随机分为实验组和对照组,每组各75例。2组均行腹腔镜阑尾炎切除术,术后实验组在常规治疗基础上加用奥曲肽皮下注射,检测治疗前后Th17、CD4+CD25+Foxp3+Treg相关指标,进而对Th17/Treg平衡状态进行分析。结果与对照组比较,实验组患者Th17/Treg失衡状态恢复较好,表现为:Th17比例、Treg比例、Th17/Treg比值下降(P<0.05);相关转录因子RORγt、Foxp3的mRNA表达水平降低(P<0.05);血清细胞相关因子(IL-4、IL-6、IL-10、IL-17、IL-23、TGF-β)、C反应蛋白(CRP)含量降低(P<0.05);血清干扰素-γ(IFN-γ)含量升高(P<0.05)。结论奥曲肽联合复合辅酶可以纠正化脓性阑尾炎患者Th17/Treg的失衡状态,提高患者的免疫功能,影响患者预后。

Objective To analyse the effect of octreotide combined with compound coenzyme on Th17/CD4 +CD25 +Foxp3 + regulatory T cells imbalance in patients with purulent appendicitis.Methods 150 patients with acute suppurative appendicitis were randomly divided into experimental group and control group, 75 cases in each group.Patients of two groups underwent appendicitis laparoscopic resection, then the control group were given conventional treatment and experimental group were given subcutaneous injection of octreotide on the basis of conventional treatment.Th17, CD4 +CD25 +Foxp3 +regulation T cells ( Treg) , and Th17 /Treg balance were analyzed.ResuIts Compared with control group, Th17/Treg imbalance of experimental group recovered better: the proportion of Th17, Treg, and Th17/Treg ratio decreased (P<0.05); the expression levels of related transcription factor, RORγt and Foxp3 mRNA decreased (P<0.05); serum cytokine (IL-4, IL-6, IL-10, IL-17, IL-23 and TGF beta) and C-reactive protein (CRP) content decreased (P<0.05);serum interferon gamma (IFN-gamma) content increased (P<0.05).ConcIusion Octreotide combined with compound coenzyme could correct Th17/Treg imbalance in suppurative appendicitis patients, improve the immune function of patients and affect the prognosis of patients.