The Evaluation Value of Treg Cells,Th17 Cells and Treg/Th17 Levels in Viral Myocarditis and Disease
10.12259/j.issn.2095-610X.S20250814
- VernacularTitle:Treg细胞、Th17细胞及Treg/Th17水平对病毒性心肌炎及病情的评估价值
- Author:
Pinyi WANG
1
;
Chong YANG
;
Jinglei YAN
Author Information
1. 定州市人民医院急诊科,河北 定州 073000
- Keywords:
Treg/Th17;
Viral myocarditis;
Disease progression;
Diagnosis;
Influencing factor
- From:
Journal of Kunming Medical University
2025;46(8):100-107
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the evaluation value of regulatory T cells(Treg),helper T cells(Th17)and Treg/Th17 changes on the morbidity and severity of viral myocarditis(VMC)patients,and further analyze the influencing factors of morbidity and severity of VMC patients.Methods Press 1∶1 The research objects were screened according to the matching principle.140 VMC patients admitted to Dingzhou People's Hospital from Janu-ary 2022 to January 2024 were selected as the observation group,and the severity of the disease was determined according to the left ventricular ejection fraction(LVEF)and serum troponin(cTnI)levels.According to the severity of the disease,the observation group was divided into a mild group(n=79)and a moderately severe group(n=61).In addition,140 healthy people in the same period were selected as the control group.All patients were followed up for one year.According to the Treg/Th17 cutoff value in the receiver operating characteristic(ROC)curve,the patients were grouped based on the expression levels of the indicators into the Treg/Th17 high-expression group(107 patients)and the Treg/Th17 low-expression group(30 patients).The levels of Treg,Th17,Treg/Th17 and baseline data were compared between the control group and the observation group.The levels of Treg,Th17,Treg/Th17 and baseline data were compared between the mild group and the moderate-severe group.The diagnostic value of the combined detection of Treg,Th17,Treg/Th17 alone and in a parallel mode for the onset and severity of the disease in patients with VMC was analyzed using the ROC curve.Multivariate Logistic regression was used to analyze the influencing factors of the onset and severity of VMC.Results During the study period,4 cases were shed in the observation group,including the study period,4 cases dropped out and 136 cases were included in the observation group,and 3 cases dropped out and 137 cases were included in the control group.Compared with the control group,Treg and Treg/Th17 in the observation group were significantly lower,and Th17 was significantly higher(P<0.05).Th17 was the risk factor affecting the incidence of VMC patients(OR=2.547,2.698),Treg and Treg/Th17 were the protective factors affecting the incidence of VMC patients(OR=0.507,0.519).The area under the curve(AUC),sensitivity and specificity of Treg,Th17 and Treg/Th17 combination in the diagnosis of VMC were higher than those of single detection.Delong's test confirmed that the AUC of the combined detection(0.893)was significantly greater than that of the individual detections of Treg(0.664,Z=7.042),Th17(0.696,Z=6.033),and Treg/Th17(0.721,Z=5.691)(P<0.05).Compared with the mild group,Treg and Treg/Th17 in the moderate and severe group were significantly lower,and Th17 was significantly higher(P<0.05).Treg and Treg/Th17 were the independent protective factors affecting the severity of VMC patients(OR=0.547,0.419),and Th17 was the independent risk factor affecting the severity of VMC patients(OR=2.554)(P<0.05).The AUC,sensitivity and specificity of Treg,Th17 and Treg/Th17 combination in detecting the severity of VMC patients were higher than those of single detection(P<0.05).During the 1-year follow-up,a total of 36 patients with VMC died.The 1-year survival rate and OS of patients with high expression of Treg/Th17 were higher than those of patients with low expression of Treg/Th17(P<0.05).Conclusion During the onset and progression of VMC,there is an imbalance in Treg/Th17 cytokines.Treg/Th17 can serve as an important indicator for detecting the deterioration of the condition in VMC patients at an early stage.Clinically,the combined detection scheme of Treg,Th17,and Treg/Th17 can be used as a reference for clinical assessment of the onset diagnosis and disease progression of VMC patients.
