Th17及其细胞因子在寻常型天疱疮患者继发感染中的价值

Value of Th17and its cytokines in pemphigus vulgaris patients with secondary infection

目的探讨辅助性T细胞17(Th17)及其细胞因子在寻常型天疱疮患者继发感染中的价值。方法自2016年12月-2017年12月,回顾性收集医院收治的寻常型天疱疮患者92例,根据患者住院期间是否发生感染,将患者分为感染组(n=41)和对照组(n=51)。主要观察指标为两组患者Th17及其细胞因子,同时观察两组患者临床特征和转归。结果寻常型天疱疮患者继发感染病例中,最常见的感染部位为皮肤感染,共有32例,占78.05%。肺部感染、败血症和尿路感染各占12.20%、4.88%和2.44%。与对照组比较,感染组患者Th17(%)显著增高(3.31±0.89vs.2.65±0.92%,P=0.001);IL-17显著增高(31.75±4.22vs.22.48±3.19pg/ml,P=0.000)。多因素logistics回归分析显示皮损积分≥4分、Th17>3%、IL-17>30pg/ml和白蛋白<30g/L是寻常型天疱疮患者继发感染的影响因素(P<0.05)。结论寻常型天疱疮感染率较高,以皮肤感染最为常见,与Th17及其细胞因子失衡有关。

OBJECTIVE To explore the value of type 17 helper T(Th17)cells and its cytokines in the pemphigus vulgaris patients with secondary infection.METHODS A total of 92 patients with pemphigus vulgaris who were treated in the hospital from Dec 2016 to Dec 2017 were retrospectively enrolled in the study and divided into the infection group with 41 cases and the control group with 51 cases according to the status of infection during the hospital stay.The Th17 and its cytokines were the major observation indexes of the two groups of patients,and the clinical characteristics and outcomes were observed and compared between the two groups of patients.RESULTS Of all the pemphigus vulgaris patients with secondary infection,32 had skin infection,accounting for 78.05%.The patients with pulmonary infection accounted for 12.20%,the patients with septicemia 4.88%,the patients with urinary tract infection 2.44%.The Th17(%)of the infection group was sighificantly higher than that of the control group(3.31±0.89 vs.2.65±0.92%,P=0.001);the IL-7 level of the infection group was sighificantly higher than that of the control group(31.75±4.22 vs.22.48±3.19 pg/ml,P=0.000).The multivariate logistic regression analysis showed that the skin lesion score no less than 4 points,Th17 more than 3%,IL-17 more than pg/ml and albumin level less than 30 g/L were the influencing factors for the secondary infection in the patients with pemphigus vulgaris(P<0.05).CONCLUSIONThe incidence of infection is high among the patients with pemphigus vulgaris,the skin infection is the most common,which is associated with the imbalance of Th17 and its cytokines.