T淋巴细胞亚群、IL-17、IL-12评估病毒性脑炎患儿预后的价值  

Value of T Lymphocyte Subsets,IL-17 and IL-12 in Evaluating the Prognosis of Children with Viral Encephalitis

作　　者：张帅[1] 王帧 许哲 ZHANG Shuai;WANG Zhen;XU Zhe(Zhengzhou Key Laboratory of Pediatric Infection and Immunity,Children’s Hospital Affiliated to Zhengzhou University,Zhengzhou 450053,China)

机构地区：[1]郑州大学附属儿童医院郑州市儿童感染与免疫重点实验室,河南郑州450053

出　　处：《河南医学研究》2025年第3期448-451,共4页Henan Medical Research

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20210672)。

摘　　要：目的探究T淋巴细胞亚群、白细胞介素-17(IL-17)、白细胞介素-12(IL-12)检测在小儿病毒性脑炎(VE)中的应用及临床价值。方法选择2019年1月至2022年1月郑州大学附属儿童医院收治的96例VE患儿(VE组),和同期健康儿童96例,VE患儿于治疗结束后根据格拉斯哥预后量表(GOS)评级分为预后良好(4~5级)、预后不良(1~3级);所有儿童均采集外周血标本,检测T淋巴细胞亚群、IL-17、IL-12水平,对比检测结果,并通过受试者工作特征(ROC)曲线及其曲线下面积(AUC)分析检测结果对VE患儿预后的评估价值。结果与对照组比较,VE组患儿CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)比值水平降低(P<0.05),CD8^(+)、IL-17、IL-12水平升高(P<0.05);VE组患儿IL-17、IL-12均与CD3^(+)(r=-0.517,-0.531,P<0.05)、CD4^(+)(r=-0.572,-0.568,P<0.05)及CD4^(+)/CD8^(+)比值(r=-0.631,-0.608,P<0.05)呈正相关,均与CD8^(+)呈负相关(r=0.508,0.537,P<0.05);VE组中,与预后良好者比较,预后不良者CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)比值水平降低(P<0.05),IL-17、IL-12水平升高(P<0.05),CD8^(+)水平比较差异无统计学意义(P>0.05);ROC曲线分析显示,CD3^(+)、CD4^(+)/CD8^(+)比值、IL-17、IL-12及四者联合评估VE预后不良的AUC为0.660、0.741、0.758、0.797、0.886,四者联合评估效能最高,诊断敏感度和特异度为90.00%和70.15%。结论VE患儿存在T淋巴细胞水平失衡和IL-17、IL-12水平升高,T淋巴细胞亚群指标与IL-17、IL-12水平存在相关性,CD3^(+)、CD4^(+)/CD8^(+)比值、IL-17、IL-12四者联合可用于评估预后。Objective To explore the application and clinical value of T lymphocyte subsets,interleukin-17(IL-17)and interleukin-12(IL-12)in children with viral encephalitis(VE).Methods A total of 96 children with VE(VE group)admitted to Children’s Hospital Affiliated to Zhengzhou University from January 2019 to January 2022 and 96 healthy children during the same period were selected.After the end of treatment,children with VE were divided into good prognosis(grade 4-5)and poor prognosis(grade 1-3)according to Glasgow outcome scale(GOS).The peripheral blood samples were collected among all children,and T lymphocyte subsets,IL-17 and IL-12 were detected,and the detection results were compared.The evaluated value of the detection results on prognosis in children with VE was analyzed by receiver characteristic operating(ROC)curve and area under curve(AUC).Results Compared with control group,the CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)ratio in VE group were significantly decreased(P<0.05),while the levels of CD8^(+),IL-17 and IL-12 were significantly increased(P<0.05).In VE group,IL-17 and IL-12 were positively correlated with CD3^(+)(r=-0.517,-0.531,P<0.05),CD4^(+)(r=-0.572,-0.568,P<0.05)and CD4^(+)/CD8^(+)ratio(r=-0.631,-0.608,P<0.05),and were negatively correlated with CD8^(+)(r=0.508,0.537,P<0.05).In VE group,the CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)ratio were significantly declined in patients with poor prognosis compared with those in patients with good prognosis(P<0.05),while the levels of IL-17 and IL-12 were significantly risen(P<0.05),but there was no statistically significant difference in CD8^(+)level(P>0.05).ROC curve analysis showed that the AUC of CD3^(+),CD4^(+)/CD8^(+)ratio,IL-17,IL-12 and the combination of the four in evaluating poor prognosis of VE were 0.660,0.741,0.758,0.797 and 0.886,and the combination of the four had the highest evaluated efficiency,and its diagnostic sensitivity and specificity were 90.00%and 70.15%.Conclusion T lymphocyte imbalance and elevated levels of IL-17 and IL-12 are present in childr

关 键 词：病毒性脑炎 儿童 T淋巴细胞亚群 白细胞介素-17 白细胞介素-12 

分 类 号：R512.3[医药卫生—内科学]