血清IL-17和外周血Treg细胞检测与308nm准分子光治疗进展期白癜风效果的相关性  

Correlation between the detection of serum IL-17 and Treg cells in peripheral blood and the effectiveness of 308 nm excimer light in the treatment of advanced vitiligo

作　　者：杜晓丽[1] 张伟 张杰娜 刘昕 王艳 闫越颖 DU Xiao-li;ZHANG Wei;ZHANG Jie-na;LIU Xin;WANG Yan;YAN Yue-ying(Department of Dermatology,Heze Municipal Hospital,Shandong Province,Heze 274000,China)

机构地区：[1]山东省菏泽市立医院皮肤科,山东菏泽274000

出　　处：《河北医科大学学报》2024年第9期1085-1089,共5页Journal of Hebei Medical University

基　　金：山东省医药卫生科技发展计划项目(202003040286)。

摘　　要：目的探讨血清白细胞介素17(interleukin-17,IL-17)和外周血调节性T细胞(T regulatory cells,Treg)检测与308 nm准分子光治疗进展期白癜风效果的相关性。方法选取山东省菏泽市立医院收治的进展期白癜风患者106例,均行308 nm准分子光治疗,治疗后6个月根据治疗效果分为无效组(n=28)和有效组(n=78),比较2组血清IL-17和外周血Treg细胞水平,分析影响308 nm准分子光治疗进展期白癜风无效的因素,采用受试者工作曲线(receiver operating curve,ROC)分析血清IL-17和外周血Treg细胞水平预测308 nm准分子光治疗进展期白癜风无效的价值。结果治疗无效组性别、年龄、病程、皮损面积、皮损部位、家族史、饮酒史、发病季节、日光暴晒、肿瘤坏死因子α、白细胞介素6、白细胞介素23、转化生长因子β、免疫球蛋白G水平与有效组比较,差异均无统计学意义(P>0.05),治疗无效组合并自身免疫性疾病、激素治疗构成比及血清IL-17水平均高于有效组(P<0.05),治疗无效组外周血Treg细胞水平低于有效组(P<0.05);Logistic多因素回归分析结果显示,合并自身免疫性疾病、IL-17、Treg细胞水平均是影响308nm准分子光治疗进展期白癜风无效的独立危险因素(P<0.05);ROC分析显示,血清IL-17和外周血Treg细胞水平预测308 nm准分子光治疗进展期白癜风无效的最佳截断点分别为20.04 ng/L和3.92%,敏感度分别为82.14%和85.71%,特异度分别为80.77%和75.64%,曲线下面积(area under the curve,AUC)分别为0.889和0.829,二者联合的特异度和AUC分别为97.44%和0.940。结论血清IL-17和外周血Treg细胞检测与308 nm准分子光治疗进展期白癜风效果有关,临床检测血清IL-17和外周血Treg细胞水平可作为预测308 nm准分子光治疗进展期白癜风效果的敏感指标,且二者联合预测价值更高。Objective To explore the correlation between the detection of serum interleukin-17(IL-17)and T regulatory cells(Treg)in peripheral blood and the effectiveness of 308 nm excimer light in the treatment of advanced vitiligo.Methods In total,106 patients with advanced vitiligo admitted to Heze Municipal Hospital were selected,and treated with 308 nm excimer light.At 6 months after treatment,they were divided into ineffective group(n=28)and effective group(n=78)according to the therapeutic effect.The levels of serum IL-17 and peripheral blood Treg cells were compared between the two groups.Factors affecting the effectiveness of 308 nm excimer light in the treatment of advanced vitiligo were analyzed.The receiver operating characteristic(ROC)curve was used to analyze the value of serum IL-17 and peripheral blood Treg cell levels in predicting the ineffectiveness of 308 nm excimer light in the treatment of advanced vitiligo.Results There was no significant difference between the ineffective group and effective group with respect to gender,age,course of disease,skin lesion area,location of skin lesion,family history,drinking history,onset season,sun exposure,tumor necrosis factorα,interleukin-6,interleukin-23,transforming growth factorβ,and immunoglobulin G level(P>0.05).The constituent ratio of patients with autoimmune diseases and receiving hormone therapy,and serum IL-17 level in ineffective group were higher than those in effective group(P<0.05),while the level of Treg cells in peripheral blood of patients in ineffective group was lower than that in effective group(P<0.05).Multivariate logistic regression analysis showed that combined autoimmune diseases,IL-17 and Treg cell levels were independent risk factors that affected the ineffectiveness of 308 nm excimer light in the treatment of advanced vitiligo(P<0.05).ROC analysis showed that the optimal cutoff points for predicting the ineffectiveness of 308 nm excimer light therapy in advanced vitiligo were 20.04 ng/L and 3.92%,respectively,The sensitivity was 82.14%an

关 键 词：白癜风 白细胞介素17 调节性T细胞 308 nm准分子光 

分 类 号：R758.41[医药卫生—皮肤病学与性病学]