当前位置:

网站首页>文章详情

外周血Th22细胞在病毒性心肌炎患者中的水平变化及临床意义

【PDF在线阅读】 【下载PDF】
  • Author:

  • Author Unit:

  • Keywords:

摘要:

目的 观察外周血Th22细胞在病毒性心肌炎患者中的水平变化及临床意义。方法 以2013年
5月至2018年5月入院的180例病毒性心肌炎患者为研究对象,按病毒性心肌炎患者病情严重程度分为轻度
组(70例)、中度组(56例)和重度组(54例);同时选取60例健康体检者为对照组。采用流式细胞仪
检测各组外周血Th22细胞水平;酶联免疫吸附法检测相关细胞因子(IL-22、IL-17)水平。分析外周血
Th22细胞对病毒性心肌炎患者病情严重程度的预测价值以及其他指标的相关性。结果 病毒性心肌炎组
患者外周血Th22细胞及细胞因子IL-22水平高于健康对照组,差异具有统计学意义(P<0.05);不同严
重程度病毒性心肌炎组间外周血Th22细胞、IL-22及IL-17水平比较,差异具有统计学意义(P<0.05)。
其中,重度组上述指标水平最高,中度组次之,轻度组最低。病毒性心肌炎患者外周血Th22细胞水平与
IL-22、IL17呈显著正相关(r=0.874,P<0.0001;r=0.865,P=0.0001)。ROC曲线分析显示,外周血Th22
细胞水平曲线下面积为0.846(95%CI:0.754~0.937),其最佳工作点为8.1%,此时预测病毒性心肌炎患
者病情严重程度的敏感性和特异性分别为76.9%和81.0%。结论 外周血Th22细胞水平与病毒性心肌炎患者
的发生、发展密切相关,对于病毒性心肌炎患者病情严重程度的预测,具有一定的临床应用价值。

Abstract:

Objective To observe the level changes and clinical significance of Th22 cells in peripheral blood
in patients with viral myocarditis (VMC). Methods VMC patients (n=180) were chosen from Daping Hospital of
Chinese PLA Army Medical University from May 2013 to May 2018, and divided according to severity of VMC,
into mild VMC group (n=70), moderate VMC group (n=56) and severe VMC group (n=54). At the same time the
healthy controls (n=60) were chosen into control group. The level changes of Th22 cells in peripheral blood were
detected by using flow cytometer, and levels of interleukin-22 (IL-22) and interleukin-17 (IL-17) were detected
by using enzyme-linked immunosorbent assay (ELISA). The predictive value of Th22 cells to severity of VMC
and correlation among Th22 cells and other indexes were analyzed. Results The levels of Th22 and IL-22 were
higher in VMC groups than those in control group (P<0.05). The difference in levels of Th22, IL-22 and IL-17 had
statistical significance among different VMC groups (P<0.05), and the highest in severe VMC group, secondarily in
moderate VMC group and lowest in mild VMC group. The level changes of Th22 cells were positively correlated to
level of IL-22 (r=0.874, P<0.0001) and level of IL17 (r=0.865, P=0.0001). The analysis of ROC showed that AUC
of Th22 cell level was 0.846 (95%CI: 0.754~0.937), optimal operating point (OOP) was 8.1%, sensitivity was 76.9%
and specificity was 81.0%. Conclusion The level changes of Th22 cells are closely correlated to the incidence and
development of VMC, and has some clinical value to predicting VMC severity in VMC patients.

基金项目:

参考文献:

[1] Dominguez F,Kühl U,Pieske B,et al. Update on Myocarditis and
Inflammatory Cardiomyopathy: Reemergence of Endomyocardial
Biopsy [J]. Rev Esp Cardiol (Engl Ed),2016,69(2):178-87.
[2] Heymans S,Eriksson U,Lehtonen J,et al. The Quest for New
Approaches in Myocarditis and Inflammatory Cardiomyopathy [J]. J
Am Coll Cardiol, 2016, 68(21):2348-64.
[3] Wang D,Li T,Cui H,et al. Analysis of the Indicating Value of Cardiac
Troponin I, Tumor Necrosis Factor-α, Interleukin-18, Mir-1 and
Mir-146b for Viral Myocarditis among Children[J]. Cell Physiol
Biochem,2016,40(6):1325-33.
[4] 林媛媛,吴乐程,孙成勇,等. 病毒性心肌炎患者外周血中Th17细
胞和调节性T细胞的变化研究[J]. 中华医院感染学杂志,2017,
27(22):5129-32.
[5] Liu X,Yang J,Deng W. The inflammatory cytokine IL-22 promotes
murine gliomas via proliferation[J]. Exp Ther Med,2017,
13(3):1087-92.
[6] 张军平,吕仕超,朱亚萍,等. 成人急性病毒性心肌炎诊断标准评价
与建议[J]. 中国医学科学院学报,2011,33(4):449-51.
[7] Alieva IN,Blagova OV,Gagarina NV,et al. Multislice spiral computed
tomography of the heart in dilated cardiomyopathy: possibilities in
the verification of myocarditis (in comparison with myocardial biopsy)

and in the evaluation of prognosis [J]. Ter Arkh,2017,89(12):15-27.

[8] 杜典国,李秀玲. 病毒性心肌炎合并心律失常患者超声心动图
表现及住院期间预后研究[J]. 中国循证心血管医学杂志,2016,
8(8):989-91.
[9] Mavrogeni S,Bratis K,Markussis V,et al. The diagnostic role of cardiac
magnetic resonance imaging in detecting myocardial inflammation in
systemic lupus erythematosus. Differentiation from viral myocarditis
[J]. Lupus,2013,22(1):34-43.
[10] 薛贻敏,林风辉,刘艳丽,等. 白细胞介素17A对柯萨奇B3病毒性心
肌炎小鼠病毒复制的影响及其机制[J]. 临床心血管病杂志,2017,
33(7):688-93.
[11] 夏天和,吴婷婷,邬涛,等. 丹参酮通过调节JAK2/STAT1通路减轻病毒
性心肌炎小鼠的心肌损伤[J]. 中华心血管病杂志,2015, (2):167-72.
[12] Huang TF,Wu XH,Wang X,et al. Fas-FasL expression and myocardial cell
apoptosis in patients with viral myocarditis[J]. Genet Mol Res, 2016,15(2).
[13] 张月婷,关玲霞,董平栓,等. IL-35抑制Th17细胞治疗柯萨奇病
毒B3诱导的病毒性心肌炎[J]. 中国循证心血管医学杂志,2018,
10(2):218-20,223.
[14] Shalaby KH,Lyons-Cohen MR,Whitehead GS,et al. Pathogenic TH17
inflammation is sustained in the lungs by conventional dendritic cells
and Toll-like receptor 4 signaling[J]. J Allergy Clin Immunol,2018,
142(4):1229-42.
[15] Affandi AJ,Silva-Cardoso SC,Garcia S,et al. CXCL4 is a novel
inducer of human Th17 cells and correlates with IL-17 and IL-22 in
psoriatic arthritis[J]. Eur J Immunol,2018,48(3):522-31.
[16] Guo D,Chen Y,Wang S,et al. Exosomes from heat-stressed tumour
cells inhibit tumour growth by converting regulatory T cells to Th17
cells via IL-6[J]. Immunology,2018,154(1):132-43.
[17] An B,Liu X,Li G,et al. Interleukin-37 Ameliorates Coxsackievirus B3-
induced Viral Myocarditis by Modulating the Th17/Regulatory T cell
Immune Response[J]. J Cardiovasc Pharmacol,2017, 69(5):305-13.

  • 2008

  • 1

通讯地址:北京市东城区东四十条南门仓5号
电话: 237499284 邮编:100700
网址:www.ebcvm..org Email: ebcvm_cj@126.com

copyright © 《中国循证心血管医学杂志》编辑部
当您在使用本网站投稿遇到困难时,
请直接将稿件投送到编辑部邮箱ebcvm_cj@126.com