| Objective To analyze the dynamic changes in the percentage of Th17,Treg cell and level of IL-17,IL-10,TGF-β1 in patients with SFTS,and to explore their significance in the occurrence and development of SFTS.Methods1.From April 2019 to October 2020,patients with SFTS who were hospitalized in the infectious diseases department were collected and divided into mild group(n=47)and critical group(n=30)according to the severity of the disease,and the corresponding healthy peoples(n=30)were included as the control group.2.The clinical records of patients with SFTS were collected,including gender,age,fever days,smoking,diabetes,COPD,hypertension,coronary heart disease,neurological symptoms,pulmonary infection and the data of WBC,PLT,ALT,AST,CK,CK-MB,ALB,LDH,C-RP(on the 5th,7th,9th,11 th,13th,15 th day of the disease course).3.The peripheral blood of patients with SFTS and healthy peoples were collected on the 5th,7th,9th,11 th,13th and 15 th day of the disease course.The percentage of Th17 Cell and Treg cell were detected by flowcytometry,and enzyme-linke dimmuno sorbent assay was applied in content of serum IL-17,IL-6,TGF-β1.Results1.Comparison of general information between mild group and critical group.The age and diabetes were closely related to the severity of SFTS(P<0.05).The fever days of critical group patients were longer(P<0.05),and they were more prone to pulmonary infection and nervous system injury(P<0.05).2.Dynamic changes of clinical laboratory indexes in patients with SFTS.The WBC counts in mild group increased gradually after admission,and that in critical group increased after maintaining low value for a few days.The PLT counts in mild group and critical group decreased to low value 2 day after admission,and then gradually recovered.ALT data in mild group and critical group decreased gradually after rising to high value 2 day after admission,besides the peak value of critical group was higher and the decline was slower than that of mild group.AST and CK data of mild group decreased gradually after admission,while those increased 2 day after admission and then decreased in critical group.The levels of CK-MB and LDH in the mild group and the critical group decreased gradually after admission.The levels of Alb in the mild group recovered rapidly after a slight decrease,and those in the critical group recovered gradually after a decrease.The levels of C-RP in the mild group decreased gradually after admission,and those in the critical group increased gradually until the 9th day of the course.3.Dynamic change in the percentage of Th17 cellCompared with the control group,the percentage of Th17 cell in the mild group increased significantly on the 5th,7th and 9th day of the disease course(P<0.05),and that of in the critical group increased significantly on each disease course(P<0.05).The percentage of Th17 increased more in the critical group than mild group on the7 th,9th,11 th,13th and 15 th day of the disease course(P<0.05).4.Dynamic change in the percentage of Treg cellCompared with the control group,the percentage of Treg cells in mild group increased only on the 7th day of the disease course(P<0.05),and that of in critical group increased on the 7th,9th,11 th,13th,15 th day of the disease course(P<0.05).The percentage of Treg increased more in the critical group than mild group on the 7th,9th,11 th,13th and 15 th day of the disease course(P<0.05).5.Dynamic changes in the content of IL-17,IL-10 and TGF-β1Compared with the control group,the level of IL-17 in mild group increased on the5 th,7th,9th and 11 th day of the disease course(P<0.05),and that of increased significantly on each disease course in critical group(P<0.05).In addition,it increased more in critical group than mild group on the 7th,9th,11 th,13th and 15 th day of the disease course(P<0.05).Compared with the control group,the level of IL-10 in mild group increased on the7 th,9th day of the disease course(P<0.05),and that of increased significantly on each course disease in critical group(P<0.05).In addition,it increased more in critical group than mild group on the 7th,9th,11 th,13th and 15 th day of the disease course(P<0.05).Compared with the control group,the level of TGF-β1 in mild group increased on the 7th,9th day of the disease course(P<0.05),and that of increased significantly on7 th,9th,11 th day of the disease course in critical group(P<0.05).In addition,it increased more in critical group than mild group on the 7th,9th,11 th day of the disease course(P< 0.05).6.Dynamic change in the ratio of Th17/TregCompared with the control group,the ratio of Th17/Treg in peripheral blood of mild patients increased significantly on the 5th,7th,9th day of the disease course(P<0.05),and that of in critical group increased significantly on each disease course(P<0.05).In addition,it increased more in critical group than mild group on the 7th,9th,11 th and 15 th day of the disease course(P<0.05).7.Correlation analysis between Th17/Treg ratio and some detection indexes in SFTSTh17/Treg ratio was negatively correlated with WBC and ALB(P<0.05),and positively correlated with ALT,AST,CK,LDH and C-RP(P<0.05).Conclusions1.We preliminarily understand the dynamic of the percentage of Th17,Treg cell and content of IL-17,IL-10 and TGF-β1 in peripheral blood in patients with SFTS.2.The percentage of Th17,Treg cell and content of IL-17,IL-10 and TGF-β1 were increased in patients with SFTS,in addition the ratio of Th17/Treg was increased,especially in the critical patients.3.The imbalance of Th17/Treg in peripheral blood of patients with SFTS is closely related to the development of disease and the degree of organ damage.4.Th17,Treg,Th17/Treg and IL-17,IL-10 and TGF-β1 test can assist SFTS in evaluating the disease and disease progression. |
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