不同病理分型脑胶质瘤切除患者Th17/Treg相关细胞因子及其与术后颅内感染的关系  

Th17/Treg related cytokines in patients with different pathological stages of glioma and their relationship with postoperative intracranial infection

作　　者：蔡春雨[1] 李琳[1] 酒晓盈 李晓彬[1] 王玲玲[1] 郑奕[1] 訾东燕 周保丹 CAI Chun-yu;LI Lin;JIU Xiao-ying;LI Xiao-bin;WANG Ling-ling;ZHENG Yi;ZI Dong-yan;ZHOU Bao-dan(Nanyang Second People's Hospital,Nanyang,Henan 473000,China)

机构地区：[1]南阳市第二人民医院神经外科,河南南阳473000

出　　处：《中华医院感染学杂志》2023年第11期1646-1649,共4页Chinese Journal of Nosocomiology

基　　金：河南省医学科技攻关联合共建基金资助项目(LHGJ20191471)。

摘　　要：目的检测不同病理分型脑胶质瘤切除患者辅助性T细胞17/调节性T细胞(Th17/Treg)平衡及相关细胞因子水平,分析与术后颅内感染的关系。方法选择2017年3月-2021年2月南阳市第二人民医院收治的87例脑胶质瘤患者作为研究对象,根据胶质瘤病理检查结果将患者分为低级别组(WHOⅠ~Ⅱ级,59例)及高级别组(WHOⅢ~Ⅳ级,28例);统计胶质瘤患者术后感染情况,采用流式细胞仪检测外周血Th17、Treg细胞水平,计算Th17/Treg;采用酶联免疫吸附法检测转化生长因子-β1(TGF-β1)、白细胞介素-6(IL-6)、IL-17水平,比较不同级别胶质瘤患者感染情况及各指标水平情况。结果高级别组患者Th17、Treg、TGF-β1、IL-6、IL-17高于低级别组(P<0.05);低级别组胶质瘤患者颅内感染发生率为5.08%(3/59)低于高级别组(P<0.05);低级别及高级别组患者中,感染患者Th17/Treg、TGF-β1、IL-6、IL-17均高于非感染患者(P<0.05);Logistic多因素分析示,高级别胶质瘤是颅内感染的危险因素(P<0.05)。结论高级别脑胶质瘤患者Th17/Treg平衡失衡及炎症因子水平异常现象高于低级别脑胶质瘤患者,这一变化可能是高级别脑胶质瘤患者感染风险较高的机制。OBJECTIVE To detect the balance of T helper 17 cells/regulatory T cells(Th17/Treg)and related cytokines in patients with different pathological stages of gliomas,and to analyze their relationship with postoperative intracranial infection.METHODS A total of 87 patients with gliomas admitted to Nanyang Second People's Hospital between Mar.2017 and Feb.2021 were selected as the study subjects,and the patients were divided into low-grade group(WHO grade Ⅰ-Ⅱ,59 cases)and high-grade group(WHO gradsⅢ-Ⅳ,28 cases)according to the pathological results.The postoperative infections of glioma patients were counted,and the levels of peripheral blood Th17 and Treg cells were detected by flow cytometry,and Th17/Treg was calculated.The levels of transforming growth factor-β1(TGF-β1),interleukin-6(IL-6)and interleukin-17(IL-17)were measured by enzyme-linked immunosorbent assay,and the infection status and levels of each index in patients with different grades of glioma were compared.RESULTS Th17,Treg,TGF-β1,IL-6,and IL-17 in the high-grade group were higher than those in the low-grade group(P<0.05).The incidence of intracranial infection in the low-grade group was 5.08%(3/59),lower than that in the high-grade group(P<0.05).Among patients with low-grade and high-grade gliomas,Th17/Treg,TGF-β1,IL-6,and IL-17 in the infected patients were higher than those in the uninfected patients(P<0.05).Multivariate logistic analysis showed that high-grade glioma was an independent risk factor for intracranial infection(P<0.05).CONCLUSION The imbalance of Th17/Treg and abnormal levels of inflammatory factors were higher in patients with high-grade gliomas than in patients with low-grade gliomas,which might be a mechanism for the higher risk of infection in patients with high-grade gliomas.

关 键 词：胶质瘤切除术 术后感染 病理分级 T淋巴细胞区群 调节性T细胞 

分 类 号：R619.3[医药卫生—外科学]