效应T细胞、调节T细胞失衡与支气管哮喘患儿病情程度的相关性及对疾病控制情况的预测价值

目的研究效应T细胞(Th)、调节T细胞(Treg)失衡与支气管哮喘患儿严重性的相关性及对疾病控制情况的预测价值。方法选取2017年7月—2018年7月于温州中西医结合医院就诊的支气管哮喘患儿124例,根据患儿疾病严重程度分为轻度组(56例)和重度组(68例),采用流式细胞仪检测患儿Th、Treg水平,分析Th、Treg及其比值与疾病严重程度的相关性;随访2个月,根据患儿复发情况分为复发组(45例)和未复发组(79例),检测Th、Treg水平并绘制预测患儿复发情况的ROC曲线。结果重度组Th和Th/Treg显著高于轻度组,Treg显著低于轻度组(均P<0.05);Pearson相关分析显示,支气管哮喘严重程度与Th、Treg及其比值有较高的相关性(r=0.651、-0.681、0.786);复发组Th、Treg及其比值显著高于未复发组(均P<0.05);ROC曲线显示,Th、Treg及其比值对支气管哮喘患儿近期复发情况具有较高的预测效能,其AUC分别为0.511、0.617和0.773,其中Th/Treg的AUC值与Th和Treg差异有统计学意义(均P<0.05);Th/Treg预测的灵敏度为82.22%,高于Th和Treg单独预测(均P<0.05)。结论效应T细胞、调节T细胞失衡与支气管哮喘患儿疾病严重度存在明显的相关性,Th和Treg的比值对于预测患儿近期复发情况具有较高的诊断效能。

Correlation between effector T cell and regulatory T cell imbalance and severity of bronchial asthma in children and its predictive value for Disease Control

Objective To study the correlation between the imbalance of effector T cells (Th) and regulatory T cells (Treg) and the severity of bronchial asthma in children and its predictive value for disease control. Methods One hundred and twenty-four children with bronchial asthma from July 2017 to July 2018 were divided into mild group (56 cases) and severe group (68 cases) according to the severity of the disease. Th and Treg levels were detected by flow cytometry, and the correlation between Th, Treg and their ratio and the severity of the disease was analyzed. The children were followed up two months to observe the recurrence of the two groups. The children were divided into recurrence group (45 cases) and non-recurrence group (79 cases), Th and Treg levels were measured and ROC curves were drawn to predict the recurrence of the two groups. Results Th and Th/Treg in severe group were significantly higher than those in mild group, while Treg was significantly lower than that in mild group (P<0.05). Pearson correlation analysis showed that the severity of bronchial asthma was highly correlated with Th, Treg and their ratios (r=0.651, -0.681, 0.786); Th, Treg and their ratios in recurrent group were significantly higher than those in mild group (P<0.05). ROC curves showed that Th, Treg and their ratios had a high predictive power for the recent recurrence of bronchial asthma in children, AUC were 0.511, 0.617 and 0.773 respectively, and the AUC value of Th/Treg was significantly higher than that of Th and Treg (P<0.05). The sensitivity of Th/Treg was 82.22%, significantly higher than those of Th and Treg. Conclusion There is a significant correlation between the imbalance of effector T cells and regulatory T cells and the severity of bronchial asthma in children, and the ratio of Th to Treg has a higher diagnostic efficiency in predicting the short-term recurrence in children.