神经梅毒患者外周血T淋巴细胞亚群水平检测 及临床意义
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浙江省医药卫生科技计划项目(2020KY769)


Detection of T-lymphocyte subsets in peripheral blood of patients with neurosyphilis and its clinical significance
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    摘要:

    目的 探讨外周血 T 淋巴细胞亚群 CD3+ 、CD4+ 、CD8+ 水平和 CD4+ /CD8+ 比值识别早期 神经梅毒的作用。方法 回顾性分析 2020 年 2 月至 2022 年 1 月杭州市西溪医院神经内科因梅毒就诊 的 100 例患者的临床资料,根据有无神经系统累及分为神经梅毒组和非神经梅毒组,每组 50 例。选取 同期我院的 50 名健康体检者作为对照组。比较患者和对照组受试者 CD3+ 、CD4+ 、CD8+ T淋巴细胞水 平和 CD4+ /CD8+ 比值。采用受试者工作特征(ROC)曲线分析外周血 T 淋巴细胞亚群识别早期神经梅毒 的价值。结果 神经梅毒组、非神经梅毒组和对照组的 CD4+ T 淋巴细胞水平分别为(30.48±4.08)%、 (32.16±4.08)%、(34.50±4.49)%,CD4+ /CD8+ 比值分别为(1.25±0.19)、(1.35±0.25)、(1.47±0.23),3 组比 较差异有统计学意义(F=11.428、11.970;P< 0.01);两两比较,差异均有统计学意义(均P< 0.05)。将神 经梅毒组患者分为早期组(n=30)、晚期组(n=20)并与对照组进行比较,结果显示 CD4+ T 淋巴细胞水平分 别为(31.23±4.28)%、(29.35±3.57)%、(34.50±4.49)%,CD4+ /CD8+ 比值分别为(1.29±0.21)、(1.18±0.13)、 (1.47±0.23),3 组比较差异有统计学意义(F=12.289、15.350;P< 0.01)。晚期组的 CD4+ T淋巴细胞水 平、CD4+ /CD8+ 比值低于对照组,CD4+ /CD8+ 比值低于早期组,差异有统计学意义(P< 0.05)。CD4+ / CD8+ 比值预测神经梅毒的 ROC 曲线下面积为 0.725(95%CI:0.645~0.805),高于 CD3+ 、CD4+ 和 CD8+ 。 结论 CD4+ T 淋巴细胞水平或 CD4+ /CD8+ 比值下降高度提示神经梅毒,CD4+ /CD8+ 比值更有助于早期识 别神经梅毒。

    Abstract:

    Objective To explore the role of T-lymphocyte subsets (CD3+ , CD4+ , CD8+ , CD4+ / CD8+ ) in early recognition of neurosyphilis. Methods A total of 100 patients with syphilis in Department of Neurology, Xixi Hospital of Hangzhou from February 2020 to January 2022 were retrospectively analyzed. There were 50 cases in neurosyphilis group and 50 cases in non-neurosyphilis group. 50 health examinees from our hospital in the same period were selected as the control group. The levels of CD3+ , CD4+ , CD8+ of T-lymphocyte and the ratio of CD4+ /CD8+ were compared among the three groups. The value of T-lymphocyte subsets in peripheral blood in identifying early neurosyphilis was analyzed by using the receiver operating characteristic (ROC) curve. Results The levels of CD4+ T-lymphocytes in the neurosyphilis group, the non neurosyphilis group and the control group were (30.48±4.08)%, (32.16±4.08)% and (34.50±4.49)%, respectively, and the CD4+ /CD8+ ratios were (1.25±0.19), (1.35±0.25) and (1.47±0.23), respectively. The differences among the three groups were statistically significant (F=11.428, 11.970; P < 0.01). The differences between every two groups were statistically significant (P< 0.05). The patients in neurosyphilis group were divided into early group (n=30) and late group (n=20) and compared with the control group. The results showed that the levels of CD4+ T-lymphocytes were (31.23±4.28)%, (29.35±3.57)%, (34.50±4.49)%, and the CD4+ /CD8+ ratios were (1.29±0.21), (1.18±0.13), (1.47±0.23), respectively. There was a statistically significant difference among the three groups (F=12.289, 15.350; P< 0.01). The CD4+ T-lymphocyte level and CD4+ /CD8+ ratio in the late stage group were lower than those in the control group, and the CD4+ /CD8+ ratio was lower than those in the early stage group, with statistically significant differences (P < 0.05). The area under the ROC curve (AUC) predicted by CD4+ /CD8+ ratio was 0.725 (95%CI:0.645-0.805), higher than that of CD3+ , CD4+ and CD8+ . Conclusions The significant decrease of CD4+ level or CD4+ / CD8+ ratio is highly suggestive of neurosyphilis, CD4+ / CD8+ is more helpful for early identification of neurosyphilis.

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白春峰,陈冠峰,朱洲,邵森.神经梅毒患者外周血T淋巴细胞亚群水平检测 及临床意义[J].神经疾病与精神卫生,2022,22(10).
DOI :10.3969/j. issn.1009-6574.2022.10.007.

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  • 在线发布日期: 2022-11-04