发作性睡病患者血清炎性因子、外周血T细胞亚群表达水平变化及其与发病的相关性研究  

Changes of serum inflammatory factors and peripheral blood T cell subsets in patients with narcolepsy and their correlations with onset

作　　者：陈雪莲 仲文强 贺嘉[1] 勾海燕[1] 陈岩[1] 朱延梅[1] Chen Xuelian;Zhong Wenqiang;He Jia;Gou Haiyan;Chen Yan;Zhu Yanmei(Epilepsy and Sleep Disorder Center,Second Affiliated Hospital of Harbin Medical University,Harbin 150086,China)

机构地区：[1]哈尔滨医科大学附属第二医院癫痫及睡眠障碍中心,哈尔滨150086

出　　处：《中华神经医学杂志》2024年第7期711-715,共5页Chinese Journal of Neuromedicine

摘　　要：目的观察发作性睡病1型(NT1)患者外周血血清肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6含量及T细胞亚群表达水平变化情况,以及其与发作性睡病的相关性,以期为寻找发作性睡病的生物学标志物提供依据。方法回顾性纳入哈尔滨医科大学附属第二医院癫痫及睡眠障碍中心自2022年3月至2023年12月收治的23例NT1患者(NT1组),以及同期在本中心进行神经系统体检的23例健康体检者(健康对照组)。采用流式细胞术检测2组受试者外周血T细胞亚群中CD4^(+)和CD8^(+)T细胞数,应用酶联免疫吸附法检测血清TNF-α及IL-6含量。采用多因素Logistic回归分析明确CD4^(+)T细胞数、IL-6含量及TNF-α含量与NT1的相关性,通过受试者工作特征(ROC)曲线下面积(AUC)评估CD4^(+)T细胞、TNF-α对NT1的诊断价值。结果与健康对照组比较,NT1组患者外周血CD4^(+)T细胞数[(820.61±316.87)个/μL vs.(1121.04±387.47)个/μL]、血清TNF-α含量[(39.97±10.64)pg/mL vs.(57.01±19.92)pg/mL]及IL-6含量[(22.50±6.09)pg/mL vs.(33.66±17.28)pg/mL]均显著增高,差异均有统计学意义(P<0.05)。2组受试者外周血CD8^(+)T细胞数[(592.52±217.78)pg/mL vs.(668.65±276.45)pg/mL]差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示CD4^(+)T细胞数和TNF-α含量是NT1的独立危险因素(OR=1.004,95%CI:1.001~1.006,P=0.007;OR=1.133,95%CI:1.032~1.243,P=0.009);两项指标联合诊断时的AUC为0.881(95%CI:0.784~0.977,P=0.001),敏感度为0.783,特异度为0.870。结论外周血CD4^(+)T细胞数和血清TNF-α含量联合诊断NT1时具有较高的效能。Objective To observe the changes of peripheral blood T cell subsets and serum tumor necrosis factor(TNF)-αand interleukin(IL)-6 contents in narcolepsy type 1(NT1)patients and their correlations with narcolepsy,and provide basis for finding the biological markers of narcolepsy.Methods A retrospective analysis was performed.From March 2022 to December 2023,23 patients with NT1 admitted to Epilepsy and Sleep Disorder Center,Second Affiliated Hospital of Harbin Medical University and 23 healthy controls underwent physical examination of nervous system in our center were enrolled.T lymphocyte subsets CD4^(+)and CD8^(+)in peripheral blood were calculated by flow cytometry.Serum TNF-αand IL-6 contents were detected by enzyme-linked immunosorbent assay.Multivariate Logistic regression was used to determine the correlations of NT1 with CD4^(+)T lymphocyte count and IL-6 and TNF-αcontents,and diagnostic values of CD4^(+)T lymphocyte and TNF-αin NT1 were evaluated via area under receiver operating characteristics(ROC)curve.Results Compared with the healthy controls,the NT1 patients had significantly increased peripheral blood CD4^(+)T lymphocyte count([820.61±316.87]/μL vs.[1121.04±387.47]/μL),and significantly higher serum TNF-αand IL-6 contents([39.97±10.64]pg/mL vs.[57.01±19.92]pg/mL;[22.50±6.09]pg/mL vs.[33.66±17.28]pg/mL,P<0.05).No significant difference in peripheral blood CD8^(+)T lymphocyte count was noted between the 2 groups([668.65±276.45]pg/mL vs.[592.52±217.78]pg/mL,P>0.05).Multivariate Logistic regression showed that CD4^(+)T lymphocyte count and serum TNF-αcontent were independent risk factors for NT1(OR=1.004,95%CI:1.001-1.006,P=0.007;OR=1.133,95%CI:1.032-1.243,P=0.009).Area under ROC curve of the two combined indexes was 0.881(95%CI:0.784-0.977,P=0.001),enjoying sensitivity of 0.783 and specificity of 0.870.Conclusion Combination of peripheral blood CD4^(+)T lymphocyte count and serum TNF-αcontent has high diagnostic performance in predicting NT1.

关 键 词：发作性睡病 白细胞介素-6 肿瘤坏死因子-Α CD4^(+)T细胞 CD8^(+)T细胞 

分 类 号：R740[医药卫生—神经病学与精神病学]