胸腔积液病人体内TREM-1和Treg细胞、DNT细胞的变化特征及其与疾病鉴别的关系  

Changes of TREM-1, Treg cells and DNT cells in patients with pleural effusion and their relationship with different diseases

作　　者：吴雅娟 刘蓉[1] 董凌云[1] 陈娟[1] WU Yajuan;LIU Rong;DONG Lingyun;CHEN Juan(Department of Respiratory and Critical Care Medicine,Wujiang Hospital Affiliated to Nantong University,Nantong 215200,China)

机构地区：[1]南通大学附属吴江医院呼吸与危重症医学科,215200

出　　处：《免疫学杂志》2021年第6期535-540,共6页Immunological Journal

摘　　要：目的胸腔积液病人积液中髓系细胞触发受体-1(TREM-1)和调节性T细胞(Treg)、双阴性T淋巴细胞(doublenegative T-cell,DNT)的变化特征及其与疾病鉴别的关系。方法选取我院于2018年2月至2019年8月获取的62例胸腔积液标本,其中肺炎旁胸腔积液患者(肺炎组)16例,恶性胸腔积液患者(恶性组)19例,结核性胸腔积液组(结核组)20例,其他原因引起的漏出液患者(漏出液组)7例。采用流式细胞术检测积液中Treg细胞、DNT细胞水平,采用酶联免疫吸附法(ELISA法)测定积液上清TREM-1水平。比较各组间TREM-1和Treg细胞、DNT细胞水平差异,并绘制ROC曲线,评价积液TREM-1和Treg细胞、DNT细胞水平在胸腔积液鉴别诊断中的意义。结果 4组患者胸腔积液TREM-1、Treg细胞、DNT细胞水平差异显著,肺炎组患者各指标均高于其他3组(P<0.05),其中漏出液组TREM-1、Treg细胞水平最低,而结核组DNT细胞水平最低。TREM-1、Treg细胞、DNT细胞诊断肺炎旁胸腔积液患者的ROC曲线下面积分别为0.843(95%CI为0.806~0.891)、0.783(95%CI为0.817~0.831)、0.756(95%CI为0.702~0.794),TREM-1、AUC值明显高于Treg细胞、DNT细胞(P<0.05),其中sTREM-I的cut-off值543.27 pg/ml,诊断准确率85.48%。TREM-1、Treg细胞、DNT细胞诊断漏出液患者的ROC曲线下面积分别为0.912(95%CI为0.875~0.951)、0.847(95%CI为0.806~0.883)、0.792(95%CI为0.758~0.834),TREM-1、AUC值明显高于Treg细胞、DNT细胞(P<0.05),其中s TREM-I的cut-off值213.18 pg/ml,诊断准确率91.94%。结论胸腔积液病人积液中TREM-1和Treg细胞、DNT细胞水平差异显著,能较好区分肺炎旁胸腔积液、漏出液,可作为鉴别胸腔积液的生物标志物。To clarify the change of TREM-1, Treg cells and DNT cells in patients with pleural effusion and their relationship with disease diagnosis, total of 62 samples of pleural effusion were collected from February 2018 to August 2019, including 16 cases of parapneumonic pleural effusion(pneumonia group), 19 cases of malignant pleural effusion(malignant group), 20 cases of tuberculous pleural effusion(tuberculosis group), and 7 cases of leakage caused by other reasons(leakage group). Flow cytometry was used to detect Treg cells and DNT, while ELISA for TREM-1. The levels of TREM-1, Treg cells and DNT cells were compared among the groups, and ROC curves were drawn to evaluate the significance of Treg cells and DNT cells in the differential diagnosis of pleural effusion. Data showed that the levels TREM-I, Treg cells and DNT cells in pleural effusion for the four groups were significantly different, and the indexes of each patient in the pneumonia group were higher than those in the other three groups(P<0.05), among which the levels of TREM-I and Treg cells in the leaking fluid group were the lowest,while the levels of DNT cells in the tuberculosis group were the lowest. The area under ROC curve(AUC) of TREM-1, Treg cells and DNT cells were 0.843(95%CI: 0.806-0.891), 0.783(95% CI: 0.817-0.831) and 0.756(95% CI: 0.702-0.794), respectively, in which the AUCvalue of TREM-1 was significantly higher than those of Treg cells and DNT cells(P<0.05). The cut off value ofsTEREM-I was 543.27 pg/ml, and the diagnostic accuracy was 85.48%. The AUC of REM-1, Treg cells and DNTcells for diagnosing leakage patients were 0.912(95% CI: 0.875-0.951), 0.847(95% CI: 0.806-0.883) and 0.792(95% CI: 0.758-0.834), respectively. The AUC value of TREM-1 was significantly higher than those of Treg cellsand DNT cells(P<0.05). The cut-off value of sTREM-I was 213.18 pg/ml, and the diagnostic accuracy was 91.94%.In conclusion, the levels of TREM-1, Treg cells and DNT cells in pleural effusion patients are significantly different,which could be used as

关 键 词：胸腔积液 人体内髓系细胞触发受体-1 调节性T细胞 双阴性T淋巴细胞 

分 类 号：R561[医药卫生—呼吸系统]