溃疡性结肠炎患者肠黏膜屏障功能与外周血Th17/Treg比值、瘦素水平的相关性  

Correlation of intestinal mucosal barrier function with Th17/Treg ratio and leptin level in peripheral blood of patients with ulcerative colitis

作　　者：宋伟[1] 罗小玲[1] SONG Wei;LUO Xiao-ling(Department of Gastroenterology,Huaian First People's Hospital,Huaian,Jiangsu 223200)

机构地区：[1]淮安市第一人民医院消化内科,江苏淮安223200

出　　处：《中国肛肠病杂志》2024年第5期40-42,共3页Chinese Journal of Coloproctology

摘　　要：目的:探讨溃疡性结肠炎(UC)患者肠黏膜屏障功能与外周血辅助性T细胞17(Th17)/调节性T细胞(Treg)比值、瘦素水平的相关性。方法:选择2019年1月至2022年12月我院收治的88例UC患者作为研究对象,根据改良Truelove和Witts评分将疾病严重程度分为轻、中、重度UC 3组,比较各组尿乳果糖/甘露醇(L/M)比值、Th17/Treg比值及瘦素水平,采用Spearman分析L/M与Th17/Treg、瘦素的相关性,绘制ROC曲线,计算Th17/Treg、瘦素预测肠黏膜屏障功能障碍的最佳截断值、敏感性和特异性。结果:重度UC组L/M、Th17/Treg比值及瘦素水平均明显高于中度UC组和轻度UC组,中度UC组L/M、Th17/Treg比值及瘦素水平高于轻度UC组,差异均有统计学意义,P<0.05。Th17/Treg比值、瘦素水平与L/M比值均呈正相关(r值分别为0.791和0.661,均P<0.05)。Th17/Treg比值、瘦素预测UC患者中重度肠黏膜屏障功能障碍发生的截断值分别为3.17、8.90 ng/mL,AUC(95%CI)为0.933(0.881~0.986)、0.903(0.843~0.964),敏感度为89.28%、81.34%,特异度为81.34%、83.47%。结论:UC患者肠黏膜屏障功能障碍严重程度与Th17/Treg比值、瘦素水平均呈正相关,监测Th17/Treg比值、瘦素水平对预测UC患者肠黏膜屏障功能障碍严重程度有较高的价值。Objective To study the correlation between intestinal mucosal barrier function with Thl7/Treg ratio and leptin level in peripheral blood of patients with ulcerative colitis(UC).Methods Total 88 patients with UC admitted to our hospital from January 2015 to December 2020 were selected as the research objects.According to the modified Truelove and Witts scores,the disease severity was divided into mild,moderate and severe UC groups.The urinary lactulose/mannitol(L/M)ratio,Th17/Treg ratio and leptin level in each group were compared.Spearman correlation analysis was used to analyze the correlation of L/M with Th17/Treg and leptin.The ROC curve was drawn to calculate the optimal cut-off value,sensitivity and specificity of Thl7/Treg and leptin in predicting intestinal mucosal barrier dysfunction.Results The L/M,Th17/Treg ratios and leptin level in the severe UC group were significantly higher than those in the moderate UC group and the mild UC group,and the L/M,Thl7/Treg ratios and leptin level in the moderate UC group were higher than those in the mild UC group,with statistically significant differences(P<0.05).Th17/Treg ratio and leptin level were positively correlated with L/M ratio(r=0.791,0.661,P<0.05).The cut-off values of Th17/Treg ratio and leptin for predicting moderate to severe intestinal mucosal barrier dysfunction in UC patients were 3.17 and 8.90 ng/mL,respectively,with AUC(95%CI)of 0.933(0.881-0.986)and 0.903(0.843-0.964),sensitivity of 89.28%and 81.34%,and specificity of 81.34%and 83.47%.Conclusion The severity of intestinal mucosal barrier dysfunction in UC patients is positively correlated with Th17/Treg ratio and leptin level,and monitoring Th17/Treg ratio and leptin level has high value in predicting the severity of intestinal mucosal barrier dysfunction in UC patients.

关 键 词：溃疡性结肠炎 肠黏膜屏障功能 乳果糖/甘露醇比值 Th17/Treg比值 瘦素 相关性 

分 类 号：R574.62[医药卫生—消化系统]