小儿消化性溃疡与Treg/Th17免疫平衡的关系  

Relationship Between Peptic Ulcer and Treg/Th17 Immune Balance in Children

作　　者：罗冲[1] 张向东[1] 刘晓政[1] 夏永欣[1] LUO Chong;ZHANG Xiangdong;LIU Xiaozheng;XIA Yongxin(Department of Gastroenterology,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院消化内科,河南南阳473000

出　　处：《河南医学研究》2023年第16期2974-2978,共5页Henan Medical Research

摘　　要：目的探讨小儿消化性溃疡与调节性T淋巴细胞(Treg)/辅助性T淋巴细胞17(Th17)免疫平衡的关系。方法选择2018年5月至2020年4月南阳市中心医院收治的125例小儿消化性溃疡为研究组,另选择同时间段来医院的59例健康体检儿童为对照组,比较研究组与对照组Treg/Th17。所有患儿均接受奥美拉唑三联疗法治疗2周,比较研究组治疗前后Treg/Th17。随访1 a,统计患儿复发情况,并比较未复发者与复发者的临床资料,以logistic回归分析法分析小儿消化性溃疡治疗后1 a内复发的危险因素,绘制受试者工作特征(ROC)曲线,以ROC曲线下面积(AUC)评估治疗前、治疗后Treg/Th17对小儿消化性溃疡治疗后1 a内复发的预测价值。结果治疗前,研究组Treg/Th17高于对照组(P<0.05);治疗2周后,研究组Treg/Th17低于治疗前(P<0.05),且高于对照组(P<0.05)。125例患儿中,幽门螺杆菌(HP)根除119例,HP根除率为95.20%,随访119例HP根除者1 a,失访2例,117例小儿消化性溃疡中复发26例,复发率为22.22%,未复发者91例。复发者年龄低于未复发者(P<0.05),复发者有抗生素滥用史例数占比、治疗2周后γ-干扰素(IFN-γ)、Treg/Th17高于未复发者(P<0.05)。logistic回归分析结果显示,有抗生素滥用史、年龄、治疗2周后Treg/Th17均为小儿消化性溃疡治疗后1 a内复发的危险因素(P<0.05)。ROC曲线结果显示,治疗2周后Treg/Th17预测小儿消化性溃疡治疗后1 a内复发的AUC值为0.786(P<0.05)。结论小儿消化性溃疡Treg/Th17异常升高,治疗2周后Treg/Th17与预后复发相关,且可作为小儿消化性溃疡治疗后1 a内复发的敏感指标。Objective To investigate the relationship between peptic ulcer in children and regulatory T lymphocyte(Treg)/helper T lymphocyte 17(Th17)immune balance.Methods A total of 125 children with peptic ulcer admitted to Nanyang Central Hospital from May 2018 to April 2020 were selected as the study group,and 59 children with healthy physical examination in the hospital at the same time period were selected as the control group.Treg/Th17 in the study group and the control group were compared.All children were treated with omeprazole triple therapy for 2 weeks.Treg/Th17 in the study group were compared before and after treatment.After 1 year of follow-up,the recurrence of the children was counted,and the clinical data of those who did not relapse and those who relapsed were compared.Logistic regression analysis was used to analyze the risk factors for recurrence of peptic ulcer in children within 1 year after treatment.The receiver operating characteristic(ROC)curve was drawn,and the area under the ROC curve(AUC)was used to evaluate the predictive value of Treg/Th17 before and after treatment for the recurrence of peptic ulcer in children within 1 year after treatment.Results Before treatment,Treg/Th17 in the study group was higher than that in the control group(P<0.05).After 2 weeks of treatment,Treg/Th17 in the study group was lower than before treatment(P<0.05)and higher than the control group(P<0.05).Among 125 children,119 cases of helicobacter pylori(HP)were eradicated,the eradication rate of HP was 95.20%,119 cases of HP eradication were followed up for 1 year,2 cases were lost to follow-up,26 cases of 117 cases of peptic ulcer recurrence in children,the recurrence rate 22.22%,91 cases did not relapse.The age of relapsers was lower than those who had not relapsed(P<0.05),and the proportion of the number of relapsers who had a history of antibiotic abuse,2 weeks after treatment,γ-interferon(IFN-γ),Treg/Th17 were higher than those who had not relapsed(P<0.05).Logistic regression analysis showed that history of anti

关 键 词：消化性溃疡 儿童 调节性T淋巴细胞/辅助性T淋巴细胞17 免疫失衡 复发 

分 类 号：R725.7[医药卫生—儿科]