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作者	单位	E-mail
刘婷	南京医科大学附属淮安第一医院耳鼻咽喉科江苏淮安 223300	ent_ar1027@163.com
许跃文	江苏省苏北人民医院血液科江苏扬州 225001
左华芹	江苏省苏北人民医院血液科江苏扬州 225001
张志存	南京医科大学附属淮安第一医院耳鼻咽喉科江苏淮安 223300
张耀庭	南京医科大学附属淮安第一医院耳鼻咽喉科江苏淮安 223300

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中文摘要:

摘要目的：探讨血清髓系细胞触发受体-1（TREM-1）、Toll样受体4（TLR4）及白细胞介素-37（IL-37）水平与变应性鼻炎（AR）患者T淋巴细胞亚群的关系研究。方法：选取2021年3月～2023年3月南京医科大学附属淮安第一医院和江苏省苏北人民医院收治的AR患者100例纳入AR组，另选取同期体检健康志愿者100名纳入对照组，根据病情程度将AR患者分为中重度AR组63例和轻度AR组37例。采用酶联免疫吸附法与流式细胞术检测血清TREM-1、TLR4、IL-37水平与外周血T淋巴细胞亚群。采用Pearson/Spearman分析AR患者血清TREM-1、TLR4、IL-37水平与外周血T淋巴细胞亚群的相关性。绘制受试者工作特征（ROC）曲线分析血清TREM-1、TLR4、IL-37水平对AR的诊断价值。结果：与对照组比较，AR组血清TREM-1、TLR4和外周血CD8⁺比例升高，血清IL-37和外周血CD3⁺、CD4⁺、CD4⁺/CD8⁺降低（P＜0.05）。与轻度AR组比较，中重度AR组血清TREM-1、TLR4和外周血CD8⁺比例升高，血清IL-37和外周血CD3⁺、CD4⁺、CD4⁺/CD8⁺降低（P＜0.05）。Pearson/Spearman相关性分析显示，AR患者血清TREM-1、TLR4水平与外周血CD3⁺、CD4⁺、CD4⁺/CD8⁺呈负相关，与外周血CD8⁺比例呈正相关（P＜0.05）；血清IL-37水平与外周血CD3⁺、CD4⁺、CD4⁺/CD8⁺呈正相关，与外周血CD8⁺比例呈负相关（P＜0.05）。ROC曲线分析显示，血清TREM-1、TLR4、IL-37水平联合诊断AR的曲线下面积为0.960，大于血清TREM-1、TLR4、IL-37水平单独预测的0.851、0.857、0.844。结论：AR患者血清TREM-1、TLR4水平升高，IL-37水平降低，与T淋巴细胞亚群异常密切相关，检测血清TREM-1、TLR4、IL-37水平有助于评估AR发病和病情进展。

英文摘要:

ABSTRACT Objective: To investigate the relationship between serum levels of triggering receptor expressed on myeloid cells-1 (TREM-1), Toll-like receptor 4 (TLR4) and interleukin-37 (IL-37) and T lymphocyte subsets in patients with allergic rhinitis (AR). Methods: 100 AR patients who were admitted to Huaian First Affiliated Hospital of Nanjing Medical University and Northern Jiangsu People's Hospital of Jiangsu Province from March 2021 to March 2023 were selected as AR group, and 100 healthy volunteers who underwent physical examination during the same period were selected as control group, AR patients were divided into moderate to severe AR group (63 cases) and mild AR group (37 cases) according to the severity of the disease. Serum TREM-1, TLR4, IL-37 levels and peripheral blood T lymphocyte subsets were detected by enzyme-linked immunosorbent assay and flow cytometry. The correlation between serum TREM-1, TLR4, IL-37 levels and peripheral blood T lymphocyte subsets in AR patients were analyzed by Pearson/Spearman. The diagnostic value of serum TREM-1, TLR4 and IL-37 levels for AR were analyzed by drawn receiver operating characteristic (ROC) curve. Results: Compared with control group, serum TREM-1, TLR4 and peripheral blood CD8⁺ ratio were increased, serum IL-37 and peripheral blood CD3⁺, CD4⁺, CD4⁺/CD8⁺ were decreased in AR group(P<0.05). Compared with mild AR group, serum TREM-1, TLR4 and peripheral blood CD8⁺ ratio were increased, serum IL-37 and peripheral blood CD3⁺, CD4⁺, CD4⁺/CD8⁺ were decreased in moderate and severe AR group(P<0.05). Pearson/Spearman correlation analysis showed that, serum TREM-1 and TLR4 levels in AR patients were negatively correlated with peripheral blood CD3⁺, CD4⁺, CD4⁺/CD8⁺, and positively correlated with peripheral blood CD8⁺ ratio (P<0.05). Serum IL-37 level was positively correlated with peripheral blood CD3⁺, CD4⁺, CD4⁺/CD8⁺, and negatively correlated with peripheral blood CD8⁺ ratio(P<0.05). ROC curve analysis showed that, the area under the curve of serum TREM-1, TLR4 and IL-37 levels in the diagnosis of AR was 0.960, which was greater than 0.851, 0.857 and 0.844 predicted by serum TREM-1, TLR4 and IL-37 levels alone. Conclusion: The levels of serum TREM-1 and TLR4 in AR patients are increase, and the level of IL-37 is decrease, which is closely relate to the abnormality of T lymphocyte subsets, the detection of serum TREM-1, TLR4 and IL-37 levels is helpful to evaluate the pathogenesis and progression of AR.

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