外周血Treg、Th1和Th2细胞占总CD4^(+)T细胞比例在初发桥本甲状腺炎中的诊断效能  

The ratio of peripheral blood Treg,Th1 and Th2 cells to total CD4^(+)T cells in the diagnosis of primary Hashimoto's thyroiditis

作　　者：汪琼[1] 于磊[1] 韩曙光 方俊 韩娟娟 金国玺[1] WANG Qiong;YU Lei;HAN Shu-guang(Department of Endocrinology,The First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,China;Department of Endocrinology,Fuyang Cancer Hospital,Fuyang 236000,China)

机构地区：[1]蚌埠医学院第一附属医院内分泌科,安徽蚌埠233004 [2]阜阳市肿瘤医院内分泌科,安徽阜阳236000

出　　处：《吉林医学》2022年第2期310-314,共5页Jilin Medical Journal

基　　金：安徽省教育厅重大项目[项目编号:KJ2019ZD29];蚌埠医学院自然科学基金重点项目[项目编号:BYKY1839ZD];蚌埠医学院科技发展基金项目[项目编号:BYKF1862]

摘　　要：目的:检测初发桥本甲状腺炎(HT)患者调节性T细胞(Treg细胞)、辅助T细胞1(Th1细胞)和辅助T细胞2(Th2细胞)占总CD4^(+)T细胞的比例。探索三者与桥本甲状腺炎的关系,比较三者在初发桥本甲状腺炎中的诊断效能,为初发桥本甲状腺炎的诊断提供新的思路。方法:随机选取初发桥本甲状腺炎患者62例,为HT组。同时选取健康体检者40例作为对照组(NC组)。检测患者甲状腺功能和抗体指标,用流式细胞仪检测Treg占CD4^(+)T细胞比例(Treg/CD4^(+)T%)、Th1占CD4^(+)T细胞的比例(Th1/CD4^(+)T%)和Th2细胞占CD4^(+)T细胞的比例(Th2/CD4^(+)T%)。使用SPSS23.0进行统计学分析,绘制ROC曲线并判断外周血Treg/CD4^(+)T%、Th1/CD4^(+)T%、Th2/CD4^(+)T%在初发桥本甲状腺炎的诊断效能。结果:t检验显示,HT组甲状腺微粒体抗体(TMAb)、甲状腺球蛋白抗体(TGAb)水平显著高于NC组,差异有统计学意义(P<0.05),HT组Treg/CD4^(+)T%、Th1/CD4^(+)T%显著低于于NC组,差异有统计学意义(P<0.05),HT组Th2/CD4^(+)T%显著高于NC组,差异有统计学意义(P<0.05)。Logistic回归结果显示,TMAb、TGAb、Th2/CD4^(+)T%是HT的独立危险因素,Treg/CD4^(+)T%是HT的独立保护因素。受试者工作特征(ROC)曲线结果显示,Treg/CD4^(+)T%、Th2/CD4^(+)T%诊断效能分别为0.813、0.823。Treg/CD4^(+)T%、Th2/CD4^(+)T%联合检测诊断效能为0.905。TMAb、TGAb联合Treg/CD4^(+)T%、Th2/CD4^(+)T%检测HT比TMAb、TGAb检测HT具有更高的诊断效能,差异有统计学意义(P<0.05)。结论:TMAb、TGAb、Th2/CD4^(+)T%是HT的独立危险因素,Treg/CD4^(+)T%是HT的独立保护因素。Treg/CD4^(+)T%、Th2/CD4^(+)T%联合诊断HT具有一定临床意义。TMAb、TGAb联合Treg/CD4^(+)T%、Th2/CD4^(+)T%诊断HT相对TMAb、TGAb有更高的诊断效能,值得在临床上进一步实行。Objective To detect regulatory T cells(Treg cells),helper T cells 1(T helper cells1)and helper T cells 2(T helper cells2)in total CD4^(+)T cells in patients with primary hashimoto's thyroiditis(HT).To explore the relationship between the three indexes and hashimoto's thyroiditis,compare the diagnostic efficacy of the three indexes in primary hashimoto's thyroiditis,and provide new ideas for the diagnosis of primary Hashimoto's thyroiditis.Method 62 Hashimoto Thyroiditis(HT)patients were randomly selected as the HT group and 40 healthy subjects were selected as Normal Control(NC)group.Thyroid function and antibody indexes of patients were detected,and the proportion of Treg to CD4^(+)T cells(Treg/CD4^(+)T%)and Th1 to CD4^(+)cells(Th1/CD4^(+)T%)and Th2 to CD4^(+)cells(Th2/CD4^(+)T%)were detected by flow cytometry.Spss23.0 was used for statistical analysis,ROC curve was drawn and diagnostic efficacy of peripheral blood Treg/CD4^(+)T%and Th1/CD4^(+)T%and Th2/CD4^(+)T%in primary hashimoto thyroiditis were determined.Results T test showed that the levels of TMAb and TGAb in HT group were significantly higher than those in normal control group,and the differences were statistically significant(P<0.05),Treg/CD4^(+)T%and Th1/CD4^(+)T%in HT group were significantly lower than those in normal control group,and the difference was statistically significant(P<0.05),Th2/CD4^(+)T%in HT group was significantly higher than that in normal control group,and the difference was statistically significant(P<0.05).Logsitic regression showed that TMAb,TGAb and Th2/CD4^(+)T%were independent risk factors for HT,and Treg/CD4^(+)T%was an independent protective factor for HT.ROC curve results showed that the diagnostic efficacy of Treg/CD4^(+)T%and Th2/CD4^(+)T%was 0.813 and 0.823,respectively.The diagnostic efficiency of Treg/CD4^(+)T%and Th2/CD4^(+)T%was 0.905.TMAb,TGAb combined with Treg/CD4^(+)T%and Th2/CD4^(+)T%showed higher diagnostic efficacy than TMAb and TGAb in detecting HT,the difference was statistically significant(P<0.05).Conclus

关 键 词：桥本甲状腺炎 诊断效能 调节性T细胞1 辅助T细胞1 辅助T细胞2 

分 类 号：R581.4[医药卫生—内分泌]