摘要
Abstract
Objective To investigate the predictive value of combined detection of peripheral blood T helper cell 17(Th17)/regulatory T cell(Treg)balance-related cytokines[interleukin-17(IL-17),interleukin-35(IL-35),IL-17/IL-35]and fecal calprotectin(FC)for perianal lesions in patients with inflammatory bowel dis-ease(IBD).Methods A total of 90 patients with IBD admitted to our hospital from June 2022 to June 2024 were enrolled and divided into a lesion group(32 cases)and a non-lesion group(58 cases)according to the presence or absence of combined perianal lesions.Baseline data,peripheral blood levels of IL-17,IL-35,IL-17/IL-35 and FC were compared between the two groups.Multivariate Logistic regression analysis was per-formed to identify independent predictive factors.Receiver operating characteristic(ROC)curves were adopted to evaluate predictive efficiency,and goodness-of-fit test was conducted.Results There were significant dif-ferences in IBD types,Crohn's disease activity index(CDAI)scores,Mayo scores,and C-reactive protein level between the two groups(P<0.05).The levels of IL-17 and FC,and IL-17/IL-35 ratio in the lesion group were higher than those in the non-lesion group(P<0.05),while the level of IL-35 was lower than that in the non-lesion group(P<0.05).Multivariate Logistic regression analysis showed that after correcting for the influence of IBD type,disease duration,clinical activity and routine laboratory indicators,elevated serum IL-17,decreased IL-35,increased IL-17/IL-35 ratio and elevated FC were independent risk factors for peri-anal lesions in patients with IBD(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of the combined detection of IL-17,IL-35,IL-17/IL-35 and FC reached 0.833(95%CI:0.736-0.915),and its predictive sensitivity and specificity were as high as 76.70%and 86.70%respectively,which was sig-nificantly better than the detection of any single indicator(P<0.05).The Hosmer-Lemeshow χ² value was 4.251,the degrees of freedom(df)=8 and P=0.834(P>0.05).Conclusion Combined detection of peripheral blood Th17/Treg balance-related factors(IL-17,IL-35,IL-17/IL-35)and FC can be used as an effective combined indicator for predicting perianal lesions in IBD patients,with favorable clinical predictive value.关键词
炎症性肠病/肛周病变/Th17/Treg/白细胞介素-17/白细胞介素-35/粪便钙卫蛋白Key words
Inflammatory bowel disease/Perianal lesions/Th17/Treg/Interleukin-17/Interleukin-35/Fecal calprotectin
