外周血Th17/Treg平衡相关指标与粪便钙卫蛋白联合检测预测炎症性肠病相关肛周病变的价值OA
Value of Combined Detection of Peripheral Blood Th17/Treg Balance-Related Indicators and Fecal Cal-protectin in Predicting Perianal Lesions Associated with Inflammatory Bowel Disease
目的:探讨外周血辅助性T细胞17(Th17)/调节性T细胞(Treg)平衡相关细胞因子[白细胞介素-17(IL-17)、白细胞介素-35(IL-35)、IL-17/IL-35]与粪便钙卫蛋白(FC)联合检测预测炎症性肠病(IBD)相关肛周病变的价值.方法:选取2022年6月至2024年6月,我院收治的90例IBD患者,根据是否合并肛周病变分为病变组32例和无病变组58例.比较两组基础资料,外周血中IL-17、IL-35、IL-17/IL-35及FC水平,采用多因素Logistic回归分析独立预测因素,受试者工作特征曲线(ROC)评估预测效能,并进行拟合度检验.结果:两组患者IBD类型、克罗恩病活动指数(CDAI)评分、梅奥评分(Mayo)、C反应蛋白比较差异均有统计学意义(P<0.05);病变组患者 IL-17水平、IL-17/IL-35比值以及 FC水平均高于无病变组(P<0.05),IL-35水平则低于无病变组(P<0.05);多因素Logistic回归分析显示,在校正了IBD类型、病程、临床活动度及常规实验室指标影响后,血清IL-17升高、IL-35降低、IL-17/IL-35比值升高和FC升高是IBD患者发生肛周病变的独立危险因素(P<0.05);ROC曲线分析显示,IL-17、IL-35、IL-17/IL-35及FC联合曲线下面积(AUC)达到0.833(95%CI:0.736-0.915),其预测灵敏度和特异度分别高达76.70%和86.70%,显著优于任何单一指标检测(P<0.05);Hosmer-Lemeshow χ²值为4.251,自由度(df)为8,P值为0.834(P>0.05).结论:外周血Th17/Treg平衡相关因子IL-17、IL-35、IL-17/IL-35和FC联合检测,可作为预测IBD患者发生肛周病变的有效组合指标,具有较好的临床预测价值.
Objective To investigate the predictive value of combined detection of peripheral blood T helper cell 17(Th17)/regulatory T cell(Treg)balance-related cytokines[interleukin-17(IL-17),interleukin-35(IL-35),IL-17/IL-35]and fecal calprotectin(FC)for perianal lesions in patients with inflammatory bowel dis-ease(IBD).Methods A total of 90 patients with IBD admitted to our hospital from June 2022 to June 2024 were enrolled and divided into a lesion group(32 cases)and a non-lesion group(58 cases)according to the presence or absence of combined perianal lesions.Baseline data,peripheral blood levels of IL-17,IL-35,IL-17/IL-35 and FC were compared between the two groups.Multivariate Logistic regression analysis was per-formed to identify independent predictive factors.Receiver operating characteristic(ROC)curves were adopted to evaluate predictive efficiency,and goodness-of-fit test was conducted.Results There were significant dif-ferences in IBD types,Crohn's disease activity index(CDAI)scores,Mayo scores,and C-reactive protein level between the two groups(P<0.05).The levels of IL-17 and FC,and IL-17/IL-35 ratio in the lesion group were higher than those in the non-lesion group(P<0.05),while the level of IL-35 was lower than that in the non-lesion group(P<0.05).Multivariate Logistic regression analysis showed that after correcting for the influence of IBD type,disease duration,clinical activity and routine laboratory indicators,elevated serum IL-17,decreased IL-35,increased IL-17/IL-35 ratio and elevated FC were independent risk factors for peri-anal lesions in patients with IBD(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of the combined detection of IL-17,IL-35,IL-17/IL-35 and FC reached 0.833(95%CI:0.736-0.915),and its predictive sensitivity and specificity were as high as 76.70%and 86.70%respectively,which was sig-nificantly better than the detection of any single indicator(P<0.05).The Hosmer-Lemeshow χ² value was 4.251,the degrees of freedom(df)=8 and P=0.834(P>0.05).Conclusion Combined detection of peripheral blood Th17/Treg balance-related factors(IL-17,IL-35,IL-17/IL-35)and FC can be used as an effective combined indicator for predicting perianal lesions in IBD patients,with favorable clinical predictive value.
顾端端;王晓佳;汪梦琴
漯河市立医院检验科(河南 漯河 462300)漯河市立医院检验科(河南 漯河 462300)漯河市立医院检验科(河南 漯河 462300)
炎症性肠病肛周病变Th17/Treg白细胞介素-17白细胞介素-35粪便钙卫蛋白
Inflammatory bowel diseasePerianal lesionsTh17/TregInterleukin-17Interleukin-35Fecal calprotectin
《中国肛肠病杂志》 2026 (6)
10-14,5
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