妊娠梅毒患者外周血中Th17和Treg细胞水平及其临床意义分析

Analysis of the Expression and Clinical Significance of Th17 and Treg Cells in the Peripheral Blood for the Pregnant Syphilis Patients

目的:探讨妊娠梅毒患者外周血中Th17和Treg细胞水平及其临床意义。方法:选择2015年4月至2016年5月我院收治的35例妊娠梅毒患者作为观察组,并选择同期进行孕检的健康孕妇30例作为对照组。分析和比较其外周血Th17和Treg细胞水平及其诊断妊娠梅毒的临床价值。结果:观察组患者外周血Th17水平显著高于对照组,而外周血Treg水平显著低于对照组(P<0.05)。多因素logistic回归分析结果显示外周血Th17和Treg水平与妊娠梅毒发病具有明显相关性。外周血Th17诊断妊娠梅毒的AUC为0.776,95%CI为0.656~0.896,外周血Treg诊断妊娠梅的ROC曲线下的面积(area under curve,AUC)为0.947,95%CI为0.897~997,Th17+Treg诊断妊娠梅毒的AUC为0.960,95%CI为0.913~1.000;Th17和Treg单独检测分别和联合检测曲线下面积比较均具有显著差异(Z=-2.807、-0.375,P<0.05);Th17+Treg联合检测的特异度、准确度分别为91.73%、93.28%,显著高于各指标单独检测(P<0.05)。结论:妊娠梅毒患者外周血Th17细胞增多,Treg细胞减少,联合检测外周血Th17和Treg细胞水平诊断妊娠梅毒具有较高的准确度,可作为诊断妊娠梅毒的重要参考指标。

Objective:To study the expression and clinical significance of Th17 and Treg cells in the peripheral blood for the pregnant syphilis patients.Methods:35 pregnant syphilis patients admitted to our hospital from April 2015 to May 2016 were selected as the observation group,and 30 healthy pregnant women were selected as the control group.The levels of Th17 and Treg cells in the peripheral blood and their clinical value for the diagnosis of pregnancy syphilis were analyzed.Results:The peripheral blood Th17 level in the observation group was significantly higher than that in the control group,while the peripheral blood Treg level was significantly lower than that in the control group(P<0.05).Multivariate logistic regression analysis showed that the levels of Th17 and Treg in the peripheral blood were significantly correlated with the incidence of pregnancy syphilis.The area under the ROC Curve(AUC)of peripheral blood Th17 for the diagnosis of pregnancy syphilis was 0.776,and the 95%ci was 0.656~0.896.The AUC of peripheral blood Treg for the diagnosis of pregnancy syphilis was 0.947,and the 95%ci was 0.897-997.The AUC of Th17+Treg for the diagnosis of pregnancy syphilis was 0.960,and the 95%ci was 0.913~1.000.The AUC of single detection of Th17 or Treg were lower than that of combination of Th17 and Treg(Z=-2.807,-0.375,P<0.05).The specificity and accuracy of combined detection of Th17+Treg were 91.73%and93.28%,respectively,which were significantly higher than those of single detection of Th17 or Treg(P<0.05).Conclusion:Peripheral blood Th17 cells were increased and Treg cells were decreased in the patients with pregnancy syphilis.Combined detection of peripheral blood Th17 and Treg cells showed higher accuracy in the diagnosis of pregnancy syphilis,which can be used as important reference index for the diagnosis of pregnancy syphilis.