免疫因子在中老年感染高危型人乳头瘤病毒宫颈病变患者中的变化及其与宫颈上皮内瘤变分级的关系  

Changes of immune factors in middle-aged and elderly patients with cervical lesions infected with high-risk human papilloma virus and their relationship with the grade of cervical intraepithelial neoplasia

作　　者：彭雪 张菁 张敏霞 PENG Xue;ZHANG Jing;ZHANG Minxia(Department of Obstetrics and Gynecology,Jiangxi Provincial Hospital of Integrated Traditional Chinese and Western Medicine,Jiangxi Province,Nanchang 330008,China;Department of Clinical Laboratory,Jiangxi Provincial Hospital of Integrated Traditional Chinese and Western Medicine,Jiangxi Province,Nanchang 330008,China)

机构地区：[1]江西省中西医结合医院妇产科,江西南昌330008 [2]江西省中西医结合医院检验科,江西南昌330008

出　　处：《中国当代医药》2024年第24期64-68,共5页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(SKJP220218478)。

摘　　要：目的探讨免疫因子在中老年感染高危型人乳头瘤病毒(HR-HPV)宫颈病变患者中的变化及其与宫颈上皮内瘤变(CIN)分级的关系。方法选取2020年9月至2022年9月江西省中西医结合医院收治的HR-HPV持续感染的126例不同宫颈病变患者作为研究对象,根据阴道镜下宫颈组织病理检查明确分为宫颈炎症组32例、CINⅠ组33例、CINⅡ组30例、CINⅢ组31例。检测各组间外周血T淋巴细胞亚群[CD3^(+)、CD4^(+)、调节性T细胞(Treg细胞)]、细胞因子[白细胞介素-10(IL-10)、白细胞介素-2(IL-2)、转化生长因子-β(TGF-β)]水平,利用Spearman相关性分析评价血T淋巴细胞亚群、细胞因子与CIN分级的关系。结果宫颈炎症组的CD3^(+)、CD4^(+)水平均高于CINⅠ组、CINⅡ组、CINⅢ组,CINⅠ组的CD3^(+)、CD4^(+)水平均高于CINⅡ组、CINⅢ组,CINⅡ组的CD3^(+)、CD4^(+)水平均高于CINⅢ组,差异有统计学意义(P<0.05);宫颈炎症组的Treg细胞水平低于CINⅠ组、CINⅡ组、CINⅢ组,CINⅠ组的Treg细胞水平低于CINⅡ组、CINⅢ组,CINⅡ组的Treg细胞水平低于CINⅢ组,差异有统计学意义(P<0.05)。宫颈炎症组的IL-2水平高于CINⅠ组、CINⅡ组、CINⅢ组,CINⅠ组的IL-2水平高于CINⅡ组、CINⅢ组,CINⅡ组的IL-2水平高于CINⅢ组,差异有统计学意义(P<0.05);宫颈炎症组的IL-10、TGF-β水平均低于CINⅠ组、CINⅡ组、CINⅢ组,CINⅠ组的IL-10、TGF-β水平均低于CINⅡ组、CINⅢ组,CINⅡ组的IL-10、TGF-β水平均低于CINⅢ组,差异有统计学意义(P<0.05)。Spearman相关性分析结果显示,T淋巴细胞亚群中,CD3^(+)、CD4^(+)与CIN分级呈负相关(r=-0.474、-0.491,P<0.05),Treg细胞与CIN分级呈正相关(r=0.397,P<0.05);细胞因子中,IL-2与CIN分级呈负相关(r=-0.557,P<0.05),IL-10、TGF-β与CIN分级呈正相关(r=0.405、0.417,P<0.05)。结论T淋巴细胞亚群、细胞因子水平变化与HR-HPV持续感染患者不同宫颈病变发生发展中发挥着重要作用,对于�Objective To investigate the changes of immune factors in middle-aged and elderly patients with cervical lesions infected with high-risk human papilloma virus(HR-HPV)and their relationship with the grade of cervical intraepithelial neoplasia(CIN).Methods A total of 126 patients with persistent HR-HPV infection with different cervical lesions admitted to Jiangxi Provincial Hospital of Integrated Traditional Chinese and Western Medicine from September 2020 to September 2022 were selected as research objects,and they were clearly divided into cervical inflammation group(32 cases),CINⅠgroup(33 cases),CINⅡgroup(30 cases),and CINⅢgroup(31 cases)according to colposcopy cervical histopathological examination.The levels of peripheral blood T lymphocyte subsets(CD3^(+),CD4^(+),regulatory T cell[Treg cell])and cytokines(interleukin-10[IL-10],interleukin-2[IL-2],transforming growth factor-β[TGF-β])were detected among the groups,and the relationship between blood T lymphocyte subsets,cytokines and CIN grade was evaluated by Spearman correlation analysis.Results The levels of CD3^(+)and CD4^(+)in cervical inflammation group were higher than those in CINⅠgroup,CINⅡgroup and CINⅢgroup,the levels of CD3^(+)and CD4^(+)in CINⅠgroup were higher than those in CINⅡgroup and CINⅢgroup,the levels of CD3^(+)and CD4^(+)in CINⅡgroup were higher than those in CINⅢgroup,and the differences were statistically significant(P<0.05).The level of Treg cells in cervical inflammation group was lower than that in CINⅠgroup,CINⅡgroup and CINⅢgroup,the level of Treg cells in CINⅠgroup was lower than that in CINⅡgroup and CINⅢgroup,the level of Treg cells in CINⅡgroup was lower than that in CINⅢgroup,the difference was statistically significant(P<0.05).The level of IL-2 in cervical inflammation group was higher than that in CINⅠgroup,CINⅡgroup and CINⅢgroup,the level of IL-2 in CINⅠgroup was higher than that in CINⅡgroup and CINⅢgroup,the level of IL-2 in CINⅡgroup was higher than that in CINⅢgroup

关 键 词：高危型人乳头瘤病毒 宫颈炎症 宫颈上皮内瘤变 T淋巴细胞亚群 细胞因子 

分 类 号：R711[医药卫生—妇产科学]