崔乐 畅晓元 许静

[摘要]目的：探討特应性皮炎（Atopic dermatitis，AD）患者外周血辅助性T细胞17（Th17）/调节性T细胞（Treg）平衡和白细胞介素-17（IL-17）、转化生长因子-β（TGF-β）的表达水平，并分析其与病情的相关性。方法：选取2015年3月-2019年6月在笔者医院确诊的AD患者126例作为观察组，再选取同期健康体检者60例作为对照组。分别检测两组静脉血中Th17、Treg细胞的百分比含量和IL-17、TGF-β水平。采用欧洲特应性皮炎评分标准（Scoring atopic dermatitis，SCORAD）对观察组病情进行评分，并分为以下三个亚组：轻度组（50例），中度组（42例），重度组（34例）。结果：观察组外周血中Th17、Th17/Treg和IL-17水平均高于对照组，Treg水平低于对照组，差异有统计学意义（P<0.05）。与对照组比较，观察组TGF-β水平降低，但差异无统计学意义（P>0.05）。重度组、中度组外周血中Th17、Th17/Treg和IL-17水平均高于轻度组，Treg、TGF-β水平均低于轻度组，差异有统计学意义（P<0.05）。重度组外周血中Th17、Th17/Treg和IL-17水平均高于中度组，Treg、TGF-β水平低于中度组，差异有统计学意义（P<0.05）。Pearson相关分析显示，患者外周血Th17/Treg、IL-17水平与其病情（SCORAD评分）之间呈正相关（r=0.930，0.893，P<0.001）。患者TGF-β水平与其病情（SCORAD评分）之间呈负相关（r=-0.912，P<0.001）。结论：AD患者外周血中Th17、Th17/Treg和IL-17水平均升高，Treg、TGF-β水平均降低，且患者Th17/Treg、IL-17、TGF-β水平均与其病情程度密切相关。因此，Th17/Treg细胞平衡在AD发病机制中发挥重要作用，在今后临床上可据此给予对应治疗。

[关键词]特应性皮炎;辅助性T细胞17;调节性T细胞;白细胞介素-17;转化生长因子-β

[中图分类号]R758.22    [文献标志码]A    [文章编号]1008-6455（2021）01-0089-04

Expression of Th17 / Treg， IL-17 and TGF-β in Peripheral Blood of Patients with Atopic Dermatitis and Correlation with the Disease

CUI Le1，CHANG Xiao-yuan1，XU Jing2

（1.Department of Dermatology，Shenyang Seventh People's Hospital，Shenyang 110003，Liaoning，China;2.Department of Dermatology，Shengjing Hospital，China Medical University，Shenyang 110003，Liaoning，China）

Abstract： Objective  To explore the balance of peripheral blood T helper cell 17 （Th17）/T regulatory cells （Treg） and interleukin-17 （IL-17） and transforming growth factor-β （TGF-β） in patients with atopic dermatitis （AD） expression level， and analyze their correlation with the condition. Methods  126 patients of AD diagnosed in our hospital from March 2015 to June 2019 were selected as the observation group， and 60 healthy medical examinees during the same period were selected as the control group. The percentage of Th17 and Treg cells and the levels of IL-17 and TGF-β in the venous blood of the two groups were detectedrespectively. The observation group was scored using the European scoring atopic dermatitis （SCORAD） and divided into the following three subgroups： the mild group （n=50）， the moderate group （n=42）， and the severe group （n=34）. Results  The levels of Th17， Th17/Treg and IL-17 in the peripheral blood of the observation group were higher than those of the control group， and the levels of Treg were lower than that of the control group， the differences were statistically significant （P<0.05）. Compared with the control group， the TGF-β level of the observation group decreased， but there was no significant difference （P>0.05）. The levels of Th17， Th17/Treg and IL-17 in peripheral blood of the severe group and the moderate group were higher than those of the mild group， while the levels of Treg and TGF-β were lower than those of the mild group （P<0.05）. The levels of Th17， Th17/Treg and IL-17 in the peripheral blood of the severe group were higher than those of the moderate group， and the levels of Treg and TGF-β were lower than those of the moderate group （P<0.05）. Pearson correlation analysis showed that the Th17/Treg and IL-17 levels in patients' peripheral blood were positively correlated with their condition （SCORAD） （r=0.930， 0.893， P<0.001）. There wasthe negativecorrelation betweenthe TGF-β level andpatient's condition （SCORAD） （r=-0.912， P<0.001）. Conclusion  The levels of Th17， Th17/Treg and IL-17 in peripheral blood of AD patients increased， while the levels of Treg and TGF-β decreased. And the levels of Th17/Treg， IL-17， and TGF-β in patients are closely related to their condition. Therefore， Th17/Treg cell balance plays an important role in the pathogenesis of AD， and can be treated accordingly in the future in the clinic.

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