The Role And Clinical Significance Of Unbalanced Expression Of Th17/Treg Cells In The Pathogenesis Of Delayed Encephalopathy Caused By Acute Carbon Monoxide Poisoning

Objective:At present,there are many studies on the relationship between delayed encephalopathy after acute carbon monoxide poisoning(DEACMP)and immunity at home and abroad.Previous studies have shown that helper T cell 17(Th17)and regulatory T cell(Treg)are closely related to neuroimmunity,but there are few studies on the imbalance of Th17/Treg expression and DEACMP.For this reason,we observed and studied the expression levels of Th17 cells,Treg cells and Th17/Treg ratio in peripheral blood of patients with DEACMP,and discussed their role in the pathogenesis of DEACMP and its clinical significance.Methods:25 patients with DEACMP were selected as the study group,20 patients with acute carbon monoxide poisoning(ACOP)were selected as the control group,and 18 healthy persons were selected as the normal control group.The curative effect of 25 patients in the study group was evaluated before discharge,and the patients were divided into two groups: effective group and ineffective group.The levels of Th17 cells and Treg cells in peripheral blood were detected by flow cytometry,and the ratio of Th17/Treg was calculated.Pairwise comparative analysis was made among normal group,ACOP group and DEACMP group,and the effective group and ineffective group after treatment in DEACMP group were compared and analyzed..Results:1.The level of Th17 cells in DEACMP group was significantly higher than that in normal group and ACOP group(P < 0.01),but there was no significant difference between ACOP group and normal group.2.The level of Treg cells in DEACMP group was significantly lower than that in normal group and ACOP group(P < 0.01),but there was no significant difference between ACOP group and normal group.3.Th17/Treg in DEACMP group was significantly higher than that in ACOP group and normal group(P < 0.05),and the difference was statistically significant,but there wasno significant difference between ACOP group and normal group.4.(1)compared with the ineffective group,the level of Th17 cells in the effective group of DEACMP treatment was significantly and strongly correlated with the efficacy of DEACMP(r=0.755,P < 0.01).The higher the level of Th17 cells was,the more ineffective the efficacy was.(2)there was a significant correlation between the level of Treg cells and the efficacy of DEACMP(r=-0.657,P < 0.01).the higher the level of Treg cells,the more effective the efficacy.(3)there is a significant and strong correlation between the ratio of Th17/Treg and the curative effect of DEACMP(r=0.785,P <0.01).The higher the ratio is,the more ineffective the curative effect is.Conclusion:1.There is an imbalance in the expression of Th17/Treg cells in patients with DEACMP,and the body is in a state of immune disorder.2.The expression level of Th17 cells,Treg cells and Th17/Treg ratio may become an index for clinical diagnosis and evaluation of DEACMP in the future.3.To provide theoretical basis for immunotherapy in which DEACMP may be based on regulating the imbalance of Th17/Treg cell expression in the future.