Treg/Th17失衡及体液免疫功能紊乱与轮状病毒性肠炎伴心肌损害患儿发病风险的关系  

Relationship between Treg/Th17 imbalance,humoral immune dysfunction and the risk of myocardial damage in children with rotavirus enteritis

作　　者：杨雨婷 张冉 汪雅[3] 张茂[1] YANG Yu-ting;ZHANG Ran;WANG Ya;ZHANG Mao(Department of Traditional Chinese Medicine,Children’s Hospital of Chongqing Medical University,National Clinical Research Center for Child Health and Disorders,Ministry of Education Key Laboratory of Child Development and Disorders,Chongqing Key Laboratory of Pediatrics,Chongqing 400015,China;Department of Children’s Health Prevention,Qujiang Community Health Service Center of Yanta District;Department of Pediatrics,Affiliated Hospital of Chengdu University of Traditional Chinese Medicine)

机构地区：[1]重庆医科大学附属儿童医院中医科国家儿童健康与疾病临床医学研究中心儿童发育疾病研究教育部重点实验室儿科学重庆市重点实验室,重庆400015 [2]西安市雁塔区曲江社区卫生服务中心儿保科 [3]成都中医药大学附属医院儿科

出　　处：《中国病原生物学杂志》2022年第6期689-692,697,共5页Journal of Pathogen Biology

摘　　要：目的探讨调节性T淋巴细胞(regulatory T lymphocyte,Treg)/辅助性T淋巴细胞(T helper lymphocyte,Th)17比例失衡及体液免疫功能紊乱与轮状病毒性肠炎伴心肌损害患儿发病风险的关系。方法选择2017年4月-2020年3月于成都中医药大学附属医院进行治疗的123例轮状病毒性肠炎伴心肌损害患儿作为观察组,选取同期收治的123例轮状病毒性肠炎无心肌损害患儿作为对照组。采用全自动生化分析仪检测血清CK-MB,采用化学发光法检测cTnI水平,采用流式细胞仪检测血清Treg、Th17水平,采用免疫比浊法检测血清免疫球蛋白水平,采用透射比浊法检测补体水平。对Treg/Th17比例失衡及体液免疫功能因素进行单因素分析及Logistics线性回归分析。结果观察组患儿的血清CK-MB和cTnI水平((73.25±27.95)U/L、(12.06±4.78)pg/ml)明显高于对照组((17.28±4.03)U/L、(11.02±1.52)pg/ml),差异具有统计学意义(t=21.981,2.230,均P<0.05)。观察组患儿的血清Treg水平((2.28±0.49)%)明显低于对照组((3.37±0.78)%),而血清Th17水平((1.66±0.25)%)显著高于对照组(0.89±0.12)%),差异具有统计学意义(t=13.124,30.745,均P<0.05)。观察组患儿的血清IgA和IgG水平((0.48±0.15)g/L、(7.59±2.13)g/L)明显低于对照组((1.02±0.39)g/L、(9.13±2.52)g/L),差异具有统计学意义(t=14.333,5.176,P<0.05),而两组患儿血清IgM水平比较((1.22±0.62)g/L vs(1.23±0.65)g/L),差异无统计学意义(t=0.123,P>0.05)。两组患儿血清C_(3)和C4水平比较((1.23±0.49)g/L vs(1.25±0.51)g/L,(0.23±0.07)g/L vs(0.22±0.08)g/L),差异无统计学意义(t=1.083,1.043,P>0.05)。单因素分析结果显示,两组患儿在Treg/Th17比例、IgA和IgG水平方面,差异具有统计学意义(χ^(2)=102.455,118.609,104.072,均P<0.05)。多因素Logistic线性回归分析结果显示,Treg/Th17比例过低、IgA和IgG水平过低是导致轮状病毒性肠炎伴心肌损害发生的危险因素。结论Treg/Th17比例失衡及体液免疫功能紊乱是轮Objective To investigate the relationship between the imbalance of regulatory T lymphocyte(Treg)/helper T lymphocyte(th)17 ratio and the disorder of humoral immune function and the risk of rotavirus enteritis with myocardial damage.Methods To investigate the relationship between the imbalance of regulatory T lymphocyte(Treg)/helper T lymphocyte(th)17 ratio and the disorder of humoral immune function and the risk of rotavirus enteritis with myocardial damage.Methods 123 children with rotavirus enteritis with myocardial damage treated in the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from April 2017 to March 2020 were selected as the observation group,and 123 children with rotavirus enteritis without myocardial damage treated in the same period were selected as the control group.Serum CK-MB was detected by automatic biochemical analyze,cTnI level was detected by chemiluminescence method,serum Treg and Th17 levels were detected by flow cytometry,serum immunoglobulin level was detected by immunoturbidimetry,and complement level was detected by transmission turbidimetry.Univariate analysis and logistic linear regression analysis were performed for factors of Treg/Th17 imbalance and humoral immune function.Results The serum levels of CK-MB and cTnI in the observation group((73.25±27.95)U/L,(12.06±4.78)pg/ml)were significantly higher than those in the control group((17.28±4.03)U/L,(11.02±1.52)pg/ml),and the differences were statistically significant(t=21.981,2.230,P0.05).There were no significant differences in serum levels of C3 and C4 between the two groups((1.23±0.49)g/L vs(1.25±0.51)g/L,(0.23±0.07)g/L vs(0.22±0.08)g/L)(t=1.083,1.043,P>0.05).Univariate analysis showed that there were statistically significant differences in Treg/Th17 ratio,IgA and IgG levels between the two groups(χ~2=102.455,118.609,104.072,P<0.05).Multivariate logistic linear regression analysis showed that low Treg/Th17 ratio,low IgA level and low IgG level were the risk factors leading to rotavirus enteriti

关 键 词：Treg/Th17比例失衡 体液免疫功能紊乱 轮状病毒性肠炎 心肌损害 

分 类 号：R378[医药卫生—病原生物学]