【摘要】 背景:Th17细胞在免疫炎症反应中发挥重要作用,其与炎症性肠病(IBD)的关系已成为相关领域的研究热点。目的:初步探讨Th17细胞在IBD发病机制中的作用以及外周血Th17细胞在IBD活动度评估中的临床意义。方法:收集来自5家医院的IBD患者81例[克罗恩病(CD)39例,溃疡性结肠炎(UC)42例]和健康志愿者40名,采集外周血标本,分离单个核细胞,经佛波酯和伊屋诺霉素联合刺激后,以流式细胞术检测外周血CD4~+T细胞中的Th17细胞比率,同时测定临床炎症指标ESR和血清CRP。结果:CD组和UC组外周血Th17细胞比率分别为2.51%±1.59%和4.15%±2.75%,均显著高于对照组的1.44%±0.73%(P均<0.05),其中UC组显著高于CD组(P<0.01),活动期CD和UC分别显著高于缓解期CD和UC(CD:3.39%±1.56%对1.48%±0.81%,P<0.01;UC:5.77%±2.77%对2.18%±0.59%,P<0.01)。Spearman秩相关系数分析显示,活动期CD和UC外周血Th17细胞比率与ESR、CRP均呈正相关(CD与ESR:r_s=0.851,CD与CRP:r_s=0.793,UC与ESR:r_s=0.817,UC与CRP:r_s=0.873,P均<0.05)。结论:Th17细胞参与了IBD的发生、发展过程,在UC发病中的作用可能更为重要。检测外周血Th17细胞比率可能有助于IBD疾病活动度的评估。更多还原

【Abstract】 Background: Th17 cells play important roles in immuno-inflammatory responses. The relationship between Th17 cells and inflammatory bowel disease( IBD) is a new hot spot of related studies. Aims: To investigate preliminarily the role of Th17 cells in the pathogenesis of IBD and the clinical significance of peripheral blood Th17 cells in evaluating disease activity. Methods: Peripheral blood mononuclear cells were collected in 81 IBD patients recruited from 5 hospitals,including 39 Crohn’s disease( CD) and 42 ulcerative colitis( UC),and also 40 healthy volunteer_s. The proportion of Th17 cells in peripheral blood CD4~+T cells was detected with flow cytometry after stimulated by PMA and ionomycin.Simultaneously,two clinical inflammatory marker_s,ESR and serum CRP were measured. Results: The proportion of peripheral blood Th17 cells was significantly higher in CD group( 2. 51% ± 1. 59%) and UC group( 4. 15% ± 2. 75%)than in control group( 1. 44% ± 0. 73%,P all < 0. 05),and that in UC group was significantly higher than in CD group( P < 0. 01). Furthermore,the proportion of peripheral blood Th17 cells in IBD patients was significantly higher in active stage than in remission stage( CD: 3. 39% ± 1. 56% vs. 1. 48% ± 0. 81%,P < 0. 01; UC: 5. 77% ± 2. 77% vs. 2. 18%± 0. 59%,P < 0. 01). In Spearman rank correlation coefficient analysis,the proportion of peripheral blood Th17 cells in active stage CD and UC was correlated significantly with ESR( r_s= 0. 851,P < 0. 05; r_s= 0. 817,P < 0. 05) and CRP( r_s= 0. 793,P < 0. 05; r_s= 0. 873,P < 0. 05). Conclusions: Th17 cells might be involved in the pathogenesis and development of IBD,especially UC. Measurement of the proportion of peripheral blood Th17 cells is beneficial for the evaluation of disease activity of IBD.更多还原