【摘要】 目的探究老年吉兰-巴雷综合征(GBS)患者外周血白细胞介素-27(IL-27)水平变化情况并分析其临床意义。方法选取本院老年GBS患者44例作为GBS组,选取同期健康体检者44例作为对照组,比较两组外周血IL-27、IL-17、IL-10水平,根据GBS组发病高峰期病情程度分为重型患者与轻型患者,对比GBS组不同病情患者临床资料、外周血IL-27、IL-17、IL-10水平,分析各指标水平变化的临床意义。结果 GBS组外周血IL-27、IL-17水平高于对照组,IL-10水平低于对照组,差异均有统计学意义(P<0.05);重型患者腹泻、自主神经功能障碍、延髓功能障碍、轴索损伤发生率均高于轻型患者,差异均有统计学意义(P<0.05);重型患者外周血IL-27、IL-17高于轻型患者,IL-10低于轻型患者(P<0.05);发病高峰期临床症状评分与外周血IL-27、IL-17呈正相关,与IL-10呈负相关(r=0.554、0.594、-0.650,P<0.05);外周血IL-27、IL-17、IL-10预测老年GBS疾病严重程度的的曲线下面积(AUC)均>0.7,各指标联合预测的AUC最大,为0.898。结论老年GBS患者外周血IL-27、IL-17水平明显升高,IL-10水平降低,各指标异常变化可能具有促进病情加重的作用,且在预测患者疾病严重程度方面具有较高应用价值。更多还原

【Abstract】 Objective To explore the changes in peripheral blood interleukin-27(IL-27)levels in elderly patients with Guillain-Barré syndrome(GBS)and analyze its clinical significance. Methods We selected 44 elderly GBS patients in our hospital as the GBS group,and 44 healthy patients during the same period as the control group. The levels of IL-27,IL-17,and IL-10 in the peripheral blood of the two groups were compared. According to the severity of the disease at the peak of the onset of the GBS group,the patients were divided into severe patients and mild patients. The clinical data,peripheral blood IL-27,IL-17,and IL-10 levels of patients with different conditions in the GBS group were compared,and the clinical significance of changes in the levels of each indicator were analyzed. Results The levels of IL-27 and IL-17 in the peripheral blood of the GBS group were higher than those of the control group,and the level of IL-10 was lower than that of the control group(P<0.05). The incidence of severe diarrhea,autonomic dysfunction,bulbar dysfunction,and axonal injury are higher than those of mild patients(P<0.05). IL-27 and IL-17 in peripheral blood in severe patients are higher than those in mild patients,IL-10 was lower than that in mild patients(P<0.05). The clinical symptom score at the peak of the disease was positively correlated with peripheral blood IL-27 and IL-17,and negatively correlated with IL-10(r=0.554,0.594,-0.650,P<0.05). The area under the curve(AUC)of peripheral blood IL-27,IL-17,and IL-10 predicting the severity of GBS disease in the elderly are all greater than 0.7,and the combined prediction of each indicator is the largest with 0.898. Conclusion The levels of IL-27 and IL-17 in the peripheral blood of elderly GBS patients are significantly increased,and the level of IL-10 is decreased. Abnormal changes in various indicators may have a role in accelerating the severity of the disease,and have a high application value in predicting the severity of the disease.更多还原