强直性脊柱炎患者外周血Th17/Treg平衡状态对疾病状况的评估价值

目的探讨强直性脊柱炎(AS)患者外周血Th17/Treg平衡状态对疾病状况的评估价值。方法选取2017年2月至2019年2月在该院确诊为AS患者90例作为AS组,同期在该院进行治疗的骶髂关节炎患者90例作为对照组。对比两组外周血Th17/Treg免疫平衡状态。进一步根据AS组的Th17/Treg比值中位数将其分为高比值组、低比值组各45例,对比两组骶髂关节病变程度、血清人类白细胞抗原B27(HLA-B27)水平、血清炎症因子肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-1β、IL-2、IL-33水平的差异。结果AS组患者外周血Th17分布比例及Th17/Treg比值高于对照组,Treg分布比例低于对照组,差异有统计学意义(P<0.05)。不同Th17/Treg比值的AS患者MRI骶髂关节病变程度比较,差异有统计学意义(P<0.05);高比值组患者的中重度比例高于低比值组,差异有统计学意义(P<0.05)。高比值组血清HLA-B27水平高于低比值组;血清TNF-α、IL-1β、IL-2、IL-33的水平高于低比值组,差异有统计学意义(P<0.05)。结论AS患者存在明显Th17/Treg失衡,Th17/Treg比值是判断AS病情的可靠指标之一。

Evaluation value of peripheral Th17/Treg balance in patients with ankylosing spondylitis

Objective To evaluate the value of Th17/Treg balance in peripheral blood of patients with ankylosing spondylitis(AS)on disease status evaluation.Methods A total of 90 cases of AS patients in a hospital from February 2017 to February 2019 were chosen as AS group,90 cases of sacroiliac arthritis patients treated in a hospital as the control group.During the same period were chosen as control group.The immune balance of Th17/Treg in peripheral blood of two groups was compared.According to the median Th17/Treg ratio of AS group,all patients were divided into high ratio group,low ratio group each with 45 cases,the differences of degree of sacroiliac joint lesions,serum human leukocyte antigen B27(HLA-B27)levels,serum inflammatory factors TNF-α,interleukin(IL)-1β,IL-2,IL-33 were compared.Results The distribution ratio of Th17,ratio of Th17/Treg in peripheral blood of AS group were higher than those in control group,while the distribution ratio of Treg was lower than that in control group,the difference was statistically significant(P<0.05).AS patients with different Th17/Treg ratios had statistically significant differences in MRI sacroiliac joint lesion degree,the difference was statistically significant(P<0.05).The moderate to severe proportion of high ratio group was higher than that in low ratio group(P<0.05).Serum HLA-B27 level in high ratio group was higher than that in low ratio group;Serum levels of TNF-α,IL-1β,IL-2 and IL-33 were higher than those of low ratio group,the difference was statistically significant(P<0.05).Conclusion AS patients have obvious Th17/Treg imbalance,and Th17/Treg ratio is one of the reliable indicators to judge the condition of AS.