调节性T细胞转录因子T-bet、GATA-3失衡表达与重症肺炎患儿病情程度及预后的关系  

Relationship of the unbalanced expression of regulatory T cell transcription factors T-BET and GATA-3 with the severity and prognosis of severe pneumonia in children

作　　者：李佳 杨保昌 郑双双 LI Jia;YANG Baochang;ZHENG Shuangshuang(Department of Clinical Laboratory,Langfang Maternal and Child Health Hospital,Langfang,Hebei 065099,China;Department of Clinical Laboratory,Hebei Central Hospital of Petro China,Langfang,Hebei 065000,China)

机构地区：[1]廊坊市妇幼保健院检验科,河北廊坊065099 [2]河北中石油中心医院检验科,河北廊坊065000

出　　处：《临床肺科杂志》2025年第3期377-382,共6页Journal of Clinical Pulmonary Medicine

基　　金：河北省重点研发计划项目(22009310815D)。

摘　　要：目的探究调节性T细胞转录因子T细胞表达的T盒(T-bet)、GATA结合蛋白3(GATA-3)失衡表达与重症肺炎患儿病情程度及预后的关系。方法选取2020年9月—2023年9月我院104例重症肺炎患儿为重症组,另以1∶1∶1比例选取104例普通肺炎患儿为轻症组,104例健康体检儿童为对照组,检测调节性T细胞转录因子T-bet、GATA-3表达水平,采用急性生理与慢性健康状况评价Ⅱ(APACHEⅡ)、肺炎严重指数(PSI)评价病情,评估治疗后7 d疗效预后。比较三组T-bet、GATA-3表达水平及PSI、APACHEⅡ评分,比较三组血清Th1/Th2细胞因子含量[白介素-2(IL-2)、IL-4、IL-10、γ干扰素(IFN-γ)、肿瘤坏死因子-α(TNF-α)],分析重症组T-bet、GATA-3与APACHEⅡ、PSI评分及血清Th1/Th2细胞因子的相关性,分析T-bet、GATA-3对重症肺炎患儿预后不良中的交互作用,比较重症组不同预后患儿T-bet、GATA-3,分析T-bet、GATA-3对患儿预后的预测价值。结果重症组T-bet mRNA、T-bet/GATA-3低于轻症组、对照组,GATA-3 mRNA、APACHEⅡ评分、PSI评分高于轻症组(P<0.05);重症组IL-2、IL-4、IL-10、IFN-γ、TNF-α均高于轻症组、对照组(P<0.05);APACHEⅡ、PSI评分与T-bet呈负相关,与GATA-3呈正相关(P<0.05),IL-2、IL-4、IL-10、IFN-γ、TNF-α与T-bet呈负相关,与GATA-3呈正相关(P<0.05);低T-bet mRNA与高GATA-3 mRNA二者同时存在时,交互作用OR为19.259,提示低T-bet mRNA与高GATA-3 mRNA在重症肺炎患儿预后不良中呈正向交互作用;19.259<4.078×11.556,提示低T-bet mRNA与高GATA-3 mRNA为次相乘模型。入院时、治疗3 d预后不良组患儿T-bet mRNA表达及T-bet/GATA-3均低于预后良好组,GATA-3 mRNA均高于预后良好组(P<0.05);入院时、治疗3 d T-bet/GATA-3预测的AUC分别为0.835(95%CI:0.750~0.901)、0.856(95%CI:0.774~0.917),大于T-bet mRNA、GATA-3 mRNA预测的AUC(P<0.05)。结论重症肺炎患儿调节性T细胞转录因子T-bet、GATA-3失衡表达与病情加重及预后有关,T-bet、GATA-3�Objective To investigate the relationship of the unbalanced expression of T-box(T-bet)and GATA binding protein 3(GATA-3)expressed by regulatory T cell transcription factor T cells with the severity and prognosis of severe pneumonia in children.Methods A total of 104 children with severe pneumonia in our hospital from September 2020 to September 2023 were selected as the severe group,104 children with common pneumonia were selected as the mild group and 104 healthy children were selected as the control group in a ratio of 1:1:1.The expression levels of regulatory T cell transcription factors T-BET and CATARA-3 were detected.Acute physiological and chronic health status Evaluation Ⅱ(APACHEⅡ)and pneumonia severity index(PSI)were used to evaluate the condition and prognosis 7 days after treatment.The expression levels of T-bet and KATA-3,PSI and APACHEⅡ scores were compared among the three groups,and the serum Th1/Th2 cytokine contents[interleukin-2(IL-2),IL-4,IL-10,IFN-γ,tumor necrosis factor-α(TNF-α)]of the three groups were compared.The correlation between T-bet,GATA-3,APACHEⅡ,PSI scores and serum Th1/Th2 cytokines in the critical group was analyzed,and the interaction of T-bet and GATA-3 on poor prognosis in children with severe pneumonia was analyzed,and T-bet and GATA-3 in children with different prognosis in the critical group were compared.The prognostic value of T-bet and GATA-3 in children was analyzed.Results T-bet mRNA and T-bet/GATA-3 in the severe group were lower than those in the mild group and the control group,and GATA-3 mRNA,APACHEⅡ score and PSI score were higher than those in the mild group(P<0.05).The levels of IL-2,IL-4,IL-10,IFN-γand TNF-α in the severe group were higher than those in the mild group and the control group(P<0.05).APACHEⅡ and PSI scores were negatively correlated with T-bet and positively correlated with GATA-3(P<0.05).IL-2,IL-4,IL-10,IFN-γ and TNF-α were negatively correlated with T-bet and positively correlated with GATA-3(P<0.05).When low T-bet mRNA and hig

关 键 词：重症肺炎 调节性T细胞转录因子 T-BET GATA-3 TH1/TH2 ROC曲线 

分 类 号：R725.6[医药卫生—儿科]