摘要
目的探讨自身免疫性脑炎患儿(AE)外周血CD4^(+)、CD8^(+)比值与其疾病转归的关系。方法选取河南科技大学第一附属医院2018年5月至2021年5月就诊的AE患儿154例,随访6个月后,根据Rankin评分评估预后分为两组(预后良好组116例,预后不良组38例),统计两组临床资料及外周血T淋巴细胞亚群指标(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)),分析AE患儿预后影响因素,依据受试者工作特征曲线(ROC)评估治疗2周后外周血T淋巴细胞亚群指标对AE患儿预后的预测价值。结果两组脑电图痫样放电、意识障碍、是否接受早期免疫治疗、发病至入院治疗时间及治疗2周后外周血CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平比较,差异有统计学意义(P<0.05);经Logistic回归方程分析,早期免疫治疗、发病至入院治疗时间较长、低水平CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、高水平CD8^(+)为AE患儿预后不良的重要影响因素,差异有统计学意义(P<0.05);经ROC曲线分析可知,治疗2周后外周血CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平联合预测AE患儿预后不良AUC 0.933优于单一指标预测AUC 0.834、0.880、0.779、0.771。结论AE患儿外周血CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平与疾病转归密切相关,临床可通过监测其水平及相关影响因素制定相应治疗措施,以改善预后。
Objective To investigate the relationship between peripheral blood CD4^(+)and CD8^(+)ratios and their disease regression in children with autoimmune encephalitis(AE).Methods A total of 154 children with AE treated in our hospital from May 2018 to May 2021 were selected,and after 6 months of follow-up,the prognosis was assessed according to the Rankin score and the patients divided into two groups(116 cases in the good prognosis group and 38 cases in the poor prognosis group),and the clinical data and peripheral blood T lymphocyte subpopulation indexes(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+))in both groups were counted to analyze the factors affecting the prognosis of children with AE,and the subject operating characteristic curve(ROC)was used to assess the predictive value of peripheral blood T lymphocyte subpopulation indexes on the prognosis of children with AE after 2 weeks of treatment.Results There were significant differences between the two groups in the comparison of EEG epileptiform discharges,impairment of consciousness,whether they received early immunotherapy,time from onset to hospital admission,and peripheral blood CD3^(+),CD4^(+),CD8^(+),and CD4^(+)/CD8^(+)levels after 2 weeks of treatment(P<0.05);By logistic regression equation analysis,early immunotherapy,longer time from onset to hospital admission,low levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+),and high levels of CD8^(+)were significant factors influencing poor prognosis in children with AE(P<0.05);As shown by ROC curve analysis,the combination of peripheral blood CD3^(+),CD4^(+),CD8^(+),and CD4^(+)/CD8^(+)levels after 2 weeks of treatment predicted poor prognosis in children with AE with an AUC 0.933 better than the single index predicted AUC 0.834,0.880,0.779,and 0.771.Conclusion Peripheral blood CD3^(+),CD4^(+),CD8^(+),and CD4^(+)/CD8^(+)levels in children with AE are closely related to disease progression,and clinical monitoring of their levels and related influencing factors can be used to develop appropriate therapeutic measures to improve
作者
高媛媛
GAO Yuanyuan(Department of Pediatrics,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang Henan 471000,China)
出处
《临床研究》
2022年第6期32-35,共4页
Clinical Research
关键词
自身免疫性脑炎
疾病转归
T淋巴细胞亚群
影响因素
autoimmune encephalitis
disease regression
T-lymphocyte subsets
influencing factors
