血清SIGIRR、sTRAIL与传染性单核细胞增多症患儿外周血T细胞亚群和肝脏损伤的关系研究  

Study on the Relationship Between Serum SIGIRR,sTRAIL and Peripheral Blood T Cell Subsets and Liver Damage in Chil-dren with Infectious Mononucleosis

作　　者：欧连声 田小珍 张鹏[1] 孟逸民 周玲[1] OU Liansheng;TIAN Xiaozhen;ZHANG Peng;MENG Yimin;ZHOU Ling(Department of Pediatrics,Qianjiang Hospital Affiliated to Chongqing University,Chongqing 409000,China)

机构地区：[1]重庆大学附属黔江医院儿科,重庆409000

出　　处：《联勤军事医学》2024年第5期391-396,共6页Military Medicine of Joint Logistics

基　　金：重庆市科卫联合医学科研项目(2022MSXM107);重庆市黔江区科技计划项目(黔科计2022040)。

摘　　要：目的 探讨传染性单核细胞增多症(infectious mononucleosis, IM)患儿血清单免疫球蛋白白细胞介素1相关受体(single immunoglobulin interleukin-1 related receptor, SIGIRR)、可溶性肿瘤坏死因子相关的凋亡诱导配体(soluble tumor necrosis factor-related apoptosis-inducing ligand, sTRAIL)与外周血T细胞亚群和肝脏损伤的关系。方法 选取2020-01/2023-01月作者医院收治的95例IM患儿为IM组,另选取同期100例体检健康儿童为对照组。根据IM患儿是否发生肝脏损伤分为肝脏损伤组(n=49)和无肝脏损伤组(n=46)。采用酶联免疫吸附试验法检测血清SIGIRR、sTRAIL水平,流式细胞术检测外周血T细胞亚群(CD3^(+)、CD16^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))。通过多因素Logistic回归分析探讨IM患儿肝脏损伤的影响因素,受试者工作特征(receiver operating characteristic, ROC)曲线分析血清SIGIRR、sTRAIL对IM患儿肝脏损伤的预测价值。结果 与对照组健康儿童比较,IM组患儿血清SIGIRR水平和外周血CD16^(+)、CD4^(+)、CD4^(+)/CD8^(+)降低,血清sTRAIL水平和外周血CD3^(+)、CD8^(+)升高(P均<0.05)。Pearson相关性分析显示,IM患儿血清SIGIRR水平与外周血CD16^(+)、CD4^(+)、CD4^(+)/CD8^(+)呈正相关关系,与CD3^(+)、CD8^(+)呈负相关关系(P<0.05),血清sTRAIL水平与外周血CD16^(+)、CD4^(+)、CD4^(+)/CD8^(+)呈负相关关系,与CD3^(+)、CD8^(+)呈正相关关系(P<0.05)。单因素分析结果显示,病程、白细胞计数、CD3^(+)、CD16^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、SIGIRR水平、sTRAIL水平为IM患儿肝脏损伤的影响因素(P均<0.05)。多因素Logistic回归分析结果显示,CD3^(+)、CD16^(+)、sTRAIL升高为IM患儿肝脏损伤的独立危险因素,CD4^(+)/CD8^(+)、SIGIRR升高为其保护因素(P<0.05)。ROC曲线分析结果显示,血清SIGIRR、sTRAIL单独和二者联合预测IM患儿肝脏损伤的曲线下面积(area under the curve, AUC)分别为0.786、0.737、0.836,二者联合对IM患儿肝脏�Objective To investigate the relationship between serum single immunoglobulin interleukin-1 related re-ceptor(SIGIRR),soluble tumor necrosis factor-related apoptosis-inducing ligand(sTRAIL)and peripheral blood T cell subsets,liver damage in children with infectious mononucleosis(IM).Methods A total of 95 IM children who were ad-mitted to author's hospital from January 2020 to January 2023 were selected as IM group,another 100 healthy children who underwent physical examination during the same period were selected as control group.Children were divided into liver damage group(n=49)and non-liver damage group(n=46)according to whether IM children had liver damage.Ser-um SIGIRR and sTRAIL levels were detected by enzyme-linked immunosorbent assay,T cell subsets in peripheral blood(CD3^(+),CD16^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+))were detected by flow cytometry.The influencing factors of liver damage in IM children were investigated by multivariate Logistic regression,the predictive value of serum SIGIRR and sTRAIL for liver damage in IM children were analyzed by receiver operating characteristic(ROC)curve.Results Compared with the healthy children in control group,ser-um SIGIRR level and peripheral blood CD16^(+),CD4^(+),CD4^(+)/CD8^(+)of patients in IM group decreased,serum sTRAIL level and peripheral blood CD3^(+),CD8^(+)increased(all P<0.05).Pearson correlation analysis showed that ser-um SIGIRR level was positively correlated with peripheral blood CD16^(+),CD4^(+)and CD4^(+)/CD8^(+)in IM children,and neg-atively correlated with CD3^(+)and CD8^(+)in IM children(P<0.05),serum sTRAIL level was negatively correlated with peripheral blood CD16^(+),CD4^(+)and CD4^(+)/CD8^(+),and positively correlated with CD3^(+)and CD8^(+)(P<0.05).Univariate analysis results showed that the courses of disease,white blood cell count,CD3^(+),CD16^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+),SIGIRR level and sTRAIL level were the influencing factors of liver damage in IM children(all P<0.05).Multi-variate Logistic regression analysis results showe

关 键 词：传染性单核细胞增多症 单免疫球蛋白白细胞介素1相关受体 可溶性肿瘤坏死因子相关的凋亡诱导配体 T细胞亚群 肝脏损伤 

分 类 号：R725.1[医药卫生—儿科]