Treg细胞在重度抑郁症患者外周血中表达及临床价值研究  

Study on the Expression of Treg Cells in Peripheral Blood of Patients with Severe Depression and Its Clinical Value

作　　者：林世泽[1] 王进义[2] LIN Shize;WANG Jinyi(Quanzhou Third Hospital Medical Department,Quanzhou 362000,China;Quanzhou Third Hospital President's Office,Quanzhou 362000,China)

机构地区：[1]泉州市第三医院医务科,福建泉州362000 [2]泉州市第三医院院长办公室,福建泉州362000

出　　处：《中华灾害救援医学》2025年第2期137-140,149,共5页Chinese Journal of Disaster Medicine

摘　　要：目的探讨外周血调节性T细胞(Regulatory T Cells,Treg)、辅助性T细胞17(Helper T Cell 17,Th17)及Th17/Treg比值与抑郁症的发生、疾病严重程度及治疗效果之间的关系。方法采用简单随机抽样法,选取2022年2月至2023年1月泉州市第三医院收治的78例抑郁症患者作为研究对象(抑郁症组),依据汉密尔顿抑郁量表(HAMD)评分将其分为轻度、中度及重度抑郁组。同期选取56名健康体检者作为对照组。检测并比较各组Treg细胞、Th17细胞及Th17/Treg比值水平,以受试者工作特征(ROC)曲线评价Treg细胞、Th17细胞及Th17/Treg比值水平对抑郁症严重程度的预测价值,及其在治疗疗效预测中的作用,并采用Delong检验预测价值的差异。结果与健康对照组相比,抑郁症患者Treg细胞水平显著降低(P<0.001),而Th17细胞水平及Th17/Treg比值显著升高(P<0.001)。Treg细胞水平与抑郁症严重程度呈负相关,且随抑郁程度加重逐渐下降;Th17细胞水平及Th17/Treg比值则与抑郁症严重程度呈正相关,并随疾病进展逐渐升高。Treg、Th17及Th17/Treg比值联合检测在预测抑郁症严重程度方面的AUC高于单独Treg细胞(P<0.001)。在疗效评估方面,与无效组相比,有效组患者Treg细胞水平较高(P<0.001),而Th17细胞水平及Th17/Treg比值较低(P<0.001)。此外,Treg及Th17细胞单独预测抑郁症治疗疗效的AUC均低于三者联合检测(P<0.001)。结论抑郁症患者外周血Treg细胞、Th17细胞及Th17/Treg比值存在显著失衡,且其联合检测可提高对抑郁症严重程度及治疗效果的评估价值,为抑郁症的病理机制研究及个体化治疗提供潜在的生物标志物。Objective To investigate the relationship between peripheral blood regulatory T cells(Tregs),helper T cell 17(Th17),and the Th17/Treg ratio with the onset,severity,and treatment outcomes of depression.Methods A simple random sampling method was employed to select 78 patients diagnosed with depression at Quanzhou Third Hospital from February 2022 to January 2023(depression group).These patients were categorized into mild,moderate,and severe depression groups based on their scores on the Hamilton Depression Rating Scale(HAMD).Concurrently,56 healthy individuals were selected as the control group.The levels of Tregs,Th17 cells,and the Th17/Treg ratio were measured and compared among the groups.The predictive value of Treg levels,Th17 levels,and the Th17/Treg ratio for depression severity was evaluated using receiver operating characteristic(ROC)curves,and the differences in predictive value were statistically tested using the DeLong method.Results Compared to the healthy control group,patients with depression exhibited a significant decrease in Treg levels(P<0.001),while Th17 cell levels and the Th17/Treg ratio were significantly elevated(P<0.001).Treg levels showed a negative correlation with depression severity,gradually declining as the severity increased.Conversely,Th17 cell levels and the Th17/Treg ratio demonstrated a positive correlation with depression severity,increasing with disease progression.The combined assessment of Tregs,Th17,and the Th17/Treg ratio yielded a higher area under the curve(AUC)for predicting depression severity compared to Tregs alone(P<0.001).In terms of treatment efficacy,patients in the effective group had higher Treg levels(P<0.001)and lower Th17 levels and Th17/Treg ratios(P<0.001)compared to the ineffective group.Additionally,the AUC for predicting treatment efficacy using Tregs or Th17 cells alone was lower than that obtained from the combined assessment of all three parameters(P<0.001).Conclusion There is a significant imbalance in peripheral blood Tregs,Th17 cells,and the Th17/

关 键 词：抑郁症 调节性T细胞 辅助性T细胞17 

分 类 号：R446[医药卫生—诊断学]