EB病毒感染紫癜性肾炎儿童Treg/Th17平衡与肾损伤程度的关系  

Relationship between Treg/Th17 balance and severity of renal damage in children with Henoch-Schonlein purpura nephritis induced by EB virus infection

作　　者：卑雪 郝佳[1] 赵丽丽 李阳[1] 刘阳[1] BEI Xue;HAO Jia;ZHAO Li-li;LI Yang;LIU Yang(Shengjing Hospital Affiliated to China Medical University,Shenyang,Liaoning 110000,China)

机构地区：[1]中国医科大学附属盛京医院小儿消化肾脏风湿免疫内科病房,辽宁沈阳110000

出　　处：《中华医院感染学杂志》2022年第14期2218-2223,共6页Chinese Journal of Nosocomiology

基　　金：辽宁省科研基金资助项目(2020S021)。

摘　　要：目的 探究EB病毒感染紫癜性肾炎(HSPN)儿童调节性T细胞/辅助性T17细胞(Treg/Th17)平衡与肾损伤程度的关系。方法 以2018年3月-2021年4月中国医科大学附属盛京医院收治的150例EB病毒感染HSPN患儿为感染组,并以同期非EB病毒感染的HSPN患儿72例为对照组,分析外周血Treg、Th17细胞比例及相关细胞因子[白细胞介素-17(IL-17)、转化生长因子β1(TGF-β1)]水平对EB病毒感染的诊断价值分析及对肾小管、肾小球损伤程度的评估价值。结果 感染组Treg细胞、Treg/Th17细胞比例及TGF-β1水平低于对照组,Th17细胞比例及IL-17水平高于对照组(P<0.05);外周血Treg细胞、Treg/Th17比例及TGF-β1水平随肾小管间质病理分级的升高呈降低趋势,Th17细胞及IL-17水平随肾小管间质病理分级的升高呈升高趋势(P<0.05);各指标联合检测评估肾小管损伤程度的AUC大于IL-17、TGF-β1水平单独检测(P<0.05);外周血Treg细胞、Treg/Th17比例及TGF-β1水平随肾小球病理分级的升高呈降低趋势,Th17细胞水平随肾小球病理分级的升高呈升高趋势(P<0.05);Treg/Th17细胞比例及IL-17、TGF-β1水平联合检测诊断EB病毒感染及评估肾小管、肾小球损伤程度的曲线下面积(AUC)大于各指标单独检测(P<0.05)。结论 HSPN患儿Treg/Th17细胞比例及IL-17、TGF-β1水平联合检测对EB病毒及肾损伤程度具有诊断评估价值,且与肾小管及肾小球损伤程度相关。OBJECTIVE To explore the relationship between balance of regulatory T cells/helper T17 cells(Treg/Th17) and severity of renal damage in the children with Henoch-Schonlein purpura nephritis induced by EB virus infection. METHODS A total of 150 children with EB virus infection-induced HSPN who were treated in Shengjing Hospital Affiliated to China Medical University from Mar 2018 to Apr 2021 were assigned as the infection group, meanwhile, 72 children with HSPN not being induced by EB virus infection were chosen as the control group. The values of percentages of peripheral blood Treg and Th17 as well as levels of related cytokines [interleukin-17(IL-17), transforming growth factor-β1(TGF-β1)] in diagnosis of EB virus infection and assessment of severity of renal tubule and glomeruli damage were observed. RESULTS The percentage of Treg, Treg/Th17 ratio and TGF-β1 were significantly lower in the infection group than in the control group, the percentage of Th17 cell and IL-17 level of the infection group were significantly higher than those of the control group(P<0.05). The percentage of peripheral blood Treg cell, Treg/Th17 ratio and TGF-β1 showed downward trends with the rise of pathological grade of renal tubulointerstitial, while the percentage of Th17 and IL-17 level showed upward trends with the rise of pathological grade of renal tubulointerstitial(P<0.05).The AUC of the joint detection of the indexes was significantly greater than that of the single detection of IL-17 or TGF-β1(P<0.05). The percentage of peripheral blood Treg cell, Treg/Th17 ratio and TGF-β1 level showed downward trend with the rise of pathological grade of glomeruli, while the Th17 level showed upward trend with the rise of pathological grade of glomeruli(P<0.05). The area under curve(AUC) of the joint detection of Treg/Th17 ratio, IL-17 and TGF-β1 was significantly greater than that of the detection of single index in diagnosis of EB virus infection and assessment of severity of renal tubule and glomeruli damage(P<0.05). CONCLUSION Th

关 键 词：EB病毒感染 儿童紫癜性肾炎 调节性T细胞/辅助性T17细胞平衡 肾损伤程度 评估价值 

分 类 号：R726.9[医药卫生—儿科]