摘要
目的探讨白癜风患者血清血小板活化因子(PAF)水平、T细胞免疫功能与疾病活动的关系。方法选择2022-07-18/2023-07-26期间在我院就诊的白癜风患者102例作为研究对象,根据白癜风疾病活动度评分(VIDA)将患者分为进展期(n=54)和稳定期(n=49),对比两组患者PAF及T淋巴细胞水平,Logistic回归分析PAF水平与疾病活动的关系及其与T细胞亚群的相关性。采用非条件Logistic回归模型分析PAF水平与T细胞亚群在疾病活动中的交互作用。结果进展期和稳定期组患者CD3^(+)水平无显著差异,进展期组患者PAF及CD8^(+)水平显著高于稳定期组患者,CD4^(+)、CD4^(+)/CD8^(+)水平则显著低于稳定期组;PAF水平评估白癜风患者疾病活动,PAF水平为18.24 ng/L时约登指数(0.670)最高,对应灵敏度和特异度分别为84.22%、82.77%,受试者工作特征(ROC)曲线下面积AUC为0.858;PAF水平与疾病活动的关联强度呈非线性剂量-反应关系(非线性检测);当VIDA评分≥1时,不同PAF水平白癜风患者CD4^(+)及CD8^(+)水平具有显著差异,不同VIDA评分白癜风患者不同PAF水平间CD4^(+)/CD8^(+)均具有显著差异;交互作用分析调整混杂因素后PAF水平与T细胞亚群对白癜风患者疾病活动影响在相加模型[相对超额危险度(RERI)=4.674,95%置信区间(CI):1.032~11.942;交互作用归因比(AP)=0.763,95%CI:0.336~1.201;交互作用指数(S)=6.854,95%CI:1.904~16.520)]和相乘模型[比值比(OR)相乘=3.461,95%CI:1.365~8.713)]中存在交互作用。结论白癜风患者血清PAF、CD4^(+)、CD8^(+)水平及CD4^(+)/CD8^(+)比值与疾病活动密切相关,且PAF水平与T细胞亚群(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))在白癜风患者疾病活动中存在交互作用。PAF水平对白癜风患者疾病活动具有一定评估价值。
Objective To investigate the relationship between serum platelet-activating factor(PAF)level,T cell immune function and disease activity in vitiligo patients.Methods A total of 102 patients with vitiligo treated in our hospital from July 18th,2022 to July 26th,2023 were enrolled as study subjects.According to VIDA score,the patients were divided into an advanced-stage group(n=54)and a stable stage group(n=49).PAF and T lymphocyte levels were compared between the two groups.Logistic regression analysis was performed to examine the relationship between PAF levels and disease activity,as well as their correlation with T cell subsets.Unconditional logistic regression modeling was employed to analyze the interaction between PAF levels and T cell subsets in disease activity.Results No significant difference was observed in CD3^(+)levels between advanced and stable stage vitiligo patients.PAF and CD8^(+)levels in advanced group were significantly higher than those in stable group,while CD4^(+)levles and CD4^(+)/CD8^(+)ratios were significantly lower than those in stable group.When PAF level was 18.24 ng/L,the maximum Youden index reached 0.670,with corresponding sensitivity of 84.22%and specificity of 82.77%.The area under ROC curve AUC was 0.858.The intensity of association between PAF level and disease activity was nonlinear dose-response relationship.Among patients with VIDA score≥1,significant differences were observed in both CD4^(+)and CD8^(+)levels across different PAF levels,and the CD4^(+)/CD8^(+)ratios in vitiligo patients with different VIDA scores was significantly different.Interaction analysis revealed that after adjusting for confounding factors,the effect of PAF levels and T cell subsets on disease activity in vitiligo patients showed significant interaction in both additive model(RERI=4.674,95%CI:1.032~11.942;AP=0.763,95%CI:0.336~1.201;S=6.854,95%CI:1.904~16.520)and multiplicative model(OR=3.461,95%CI:1.365~8.713).Conclusion Serum PAF,CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)of vitiligo patients are closely related to disease activity,and PAF level interacts with T cell subsets(CD4^(+),CD8^(+),CD4^(+)/CD8^(+))in the disease activity of vitiligo patients.PAF and T cell immune function may contribute to the occurrence and development of vitiligo,which could serve as clinical indicators of disease activity to guide timely management.
作者
刘懿
李小平
陈尧
LIU Yi;LI Xiaoping;CHEN Yao(Department of Dermatology,Nanxishan Hospital,Guangxi Zhuang Autonomous Region,The Second People’s Hospital of Guangxi Zhuang Autonomous Region,Guilin 541002,China)
出处
《细胞与分子免疫学杂志》
北大核心
2025年第8期717-723,共7页
Chinese Journal of Cellular and Molecular Immunology
基金
广西壮族自治区卫生健康委员会自筹经费科研课题(Z-C20220188)。
作者简介
刘懿(1983-),女,广西桂林人,副主任医师,硕士研究生Tel:18977324866,E-mail:liuyi6660@163cn.email;通讯作者:刘懿,E-mail:liuyi6660@163cn.email。
