血清IL-17A、NLR、TGF-β在儿童克罗恩病活动期的表达及其诊断价值  

Expression of serum IL-17A,NLR,TGF-β and its diagnostic value in children with Crohn's disease at active stage

作　　者：孙波[1] 周方 薛福敏[1] 李小芹 SUN Bo;ZHOU Fang;XUE Fu-min;LI Xiao-qin(Department of Gastroenterology,Childrens Hospital Affiliated to Zhengzhou University,Zhengzhou 450018,China)

机构地区：[1]郑州大学附属儿童医院消化内科,郑州450018

出　　处：《医药论坛杂志》2024年第12期1328-1331,1337,共5页Journal of Medical Forum

基　　金：河南省科技攻关项目(212102310037)。

摘　　要：目的探讨血清白细胞介素17A(IL-17A)、中性粒细胞/淋巴细胞比值(NLR)、转化生长因子β(TGF-β)对儿童克罗恩病活动期的表达及其预测价值。方法选取2019年7月—2022年8月在郑州大学附属儿童医院消化内科诊治的克罗恩病患儿40例,总住院为85例次,按照儿童克罗恩病活动指数(PCDAI)分为缓解期组41例次、轻度活动期组25例次和中重度活动期组19例次;选取同期健康体检儿童40例(40例次)作为对照组,比较各组血清IL-17A、NLR、TGF-β,并采用受试者工作特征(ROC)曲线分析血清IL-17A、NLR、TGF-β对克罗恩病活动期的预测价值。结果不同PCDAI克罗恩病患儿与对照组血清IL-17A、NLR、TGF-β比较:中重度活动期组(134.42±35.35、4.05±1.93、53.63±15.90)>轻度活动期组(111.56±36.67、2.80±1.00、32.68±10.77)>缓解期组(95.12±24.15、1.93±0.65、23.66±7.86)>对照组(83.30±22.93、1.28±0.45、18.30±6.64),差异均有统计学意义。ROC曲线分析显示,IL-17A、NLR、TGF-β、三者联合预测克罗恩病患儿活动期的曲线下面积(AUC)分别为0.717、0.781、0.838、0.893,约登指数分别为0.683、0.488、0.612、0.669,在最佳临界值点对应的敏感度、特异度分别为:IL-17A为70.5%、68.3%,NLR为65.9%、82.9%,TGF-β为63.6%、97.6%,三者联合为80.5%、86.4%。结论克罗恩病儿童活动期血清IL-17A、NLR、TGF-β呈高表达,血清IL-17A、NLR、TGF-β三者联合可较好预测克罗恩病儿童活动期。Objective To explore the expression and predictive value of interleukin-17A(IL-17A),neutrophil to lymphocyte ratio(NLR)and transforming growth factor β(TGF-β).On the active stage of Crohn's disease in children.Methods Totally 40 children with Crohn's disease who were diagnosed and treated in the Department of Gastroenterology of the Affiliated Children's Hospital of Zhengzhou University from July 2019 to August 2022 were selected.The total number of hospitalizations was 85.According to the Children's Crohn's Disease Activity Index(PCDAI),they were divided into remission group(41 times),mild activity group(25 times)and moderate activity group(19 times),compare the serum levels of IL-17A,NLR,and TGF-β in each group,and using receiver operating characteristic(ROC)curves analyzed the predictive value of serum IL-17A,NLR,and TGF-β for the active phase of Crohn's disease.Results Comparsion of serum IL-17A,NLR,TGF-β in children with Crohn's disease of different PCDAI and controls:moderate and severe activity group(134.42±35.35,4.05±1.93,53.63±15.90)>mild activity group(111.56±36.67,2.80±1.00,32.68±10.77)>remission group(95.12±24.15,1.93±0.65,23.66±7.86)>control group(83.30±22.93,1.28±0.45,18.30±6.64),which were statistically significant.ROC curve analysis shows that,the area under the curve(AUC)of IL-17A,NLR,TGF-β,and their combined prediction of active phase in children with Crohn's disease were 0.717,0.781,0.838,and 0.893,the Joden index was 0.683,0.488,0.612 and 0.669 respectively,and the corresponding sensitivity and specificity at the best critical value point were:IL-17A was 70.5%,68.3%,NLR was 65.9%,82.9%,TGF-β 63.6%,97.6%,80.5% and 86.4%respectively.Conclusion Children with Crohn's disease during the active phase exhibit high expression of serum IL-17A,NLR,and TGF-β,the combination of serum IL-17A,NLR,and TGFβcan effectively predict the active phase of children with Crohn's disease.

关 键 词：白细胞介素17A 中性粒细胞/淋巴细胞比值 转化生长因子Β 儿童 克罗恩病 活动期 

分 类 号：R725.7[医药卫生—儿科]