Th1/Th2细胞因子在人偏肺病毒肺炎患儿疗效评价中的作用

doi:10.19871/j.cnki.xfcrbzz.2025.05.004

摘要/Abstract

摘要： 目的探讨辅助型T细胞1/辅助型T细胞2（T helper cell type 1/T helper cell type 2,Th1/Th2）细胞因子水平与人偏肺病毒肺炎患儿疗效的关系,评价其作为疗效预测生物标志物的潜在价值,为临床治疗方案的优化提供理论依据。方法选取2022年1月至2024年1月河北省儿童医院收治的156例人偏肺病毒肺炎患儿作为研究对象,采取对症支持治疗,根据治疗效果分为有效组（134例）和无效组（22例）,比较两组患儿一般资料、肺功能指标、Th1细胞因子[干扰素-γ（interferon-γ,IFN-γ）、白细胞介素-2（interleukine-2,IL-2）]和Th2细胞因子（IL-4、IL-6）水平,采用Pearson分析Th1/Th2细胞因子与肺功能指标的相关性,采用Logistic回归分析Th1/Th2细胞因子水平对人偏肺病毒肺炎疗效的影响,绘制受试者操作特征曲线（receiver operating characteristic curve,ROC曲线）,计算曲线下面积（area under curve,AUC）,分析Th1/Th2细胞因子水平对疗效的预测价值。结果与有效组比较,无效组患儿呼吸比（spiratory time/expiratory time,TI/TE）、潮气量（tidal volume,VT）、IFN-γ、IL-2较低,呼吸频率（respiratory rate,RR）、IL-4、IL-6及病情程度中度占比较高（P< 0.05）。IFN-γ、IL-2与TI/TE、VT呈正相关,与RR呈负相关;IL-4、IL-6与TI/TE、VT呈负相关,与RR呈正相关（P<0.05）。校正混杂因素后,IFN-γ、IL-2、IL-4、IL-6水平与人偏肺病毒肺炎患儿疗效相关（P<0.05）。IFN-γ、IL-2、IL-4、IL-6联合预测人偏肺病毒肺炎疗效的价值优于单一指标预测（AUC：0.927、0.805、0.791、0.789、0.777）。结论 IFN-γ、IL-2、IL-4、IL-6是人偏肺病毒肺炎患儿疗效的影响因素,且与肺功能指标密切相关,可联合应用于疗效的预测,有助于指导临床诊治。

关键词: 人偏肺病毒, 肺炎, Th1/Th2细胞因子, 疗效

Abstract: Objective The objective of this study was to explore the relationship between T helper cell type 1/T helper cell type 2 (Th1/Th2) cytokines and the therapeutic efficacy in children with human metapneumovirus pneumonia, and to assess their potential value as biomarkers for predicting therapeutic efficacy, thereby providing a theoretical basis for optimizing clinical treatment strategies. Method A total of 156 pediatric patients with human metapneumovirus pneumonia admitted to Hebei Children's Hospital from January 2022 to January 2024 were selected as the study subjects. Symptomatic supportive treatment was administered, and the patients were divided into an effective group(134 cases) and an ineffective group(22 cases) based on treatment efficacy. General information, pulmonary function indicators, Th1 cytokines [interferon-γ (IFN-γ), interleukin-2 (IL-2)], and Th2 cytokines (IL-4, IL-6) of the two groups were compared. Pearson correlation analysis was used to examine the correlation between Th1/Th2 cytokines and pulmonary function indicators. Logistic regression analysis was conducted to investigate the impact of Th1/Th2 cytokines on the efficacy of treatment for human metapneumovirus pneumonia. Receiver operating characteristic (ROC) curves were plotted, and the area under the curve (AUC) was calculated to evaluate the predictive value of Th1/Th2 cytokines for treatment efficacy. Result Compared with the effective group, the ineffective group had lower respiratory ratio (spiratory time/expiratory time, TI/TE), tidal volume (VT), IFN-γ, and IL-2 levels, and higher respiratory rate (RR), IL-4, IL-6 levels, and moderate disease severity (P<0.05). IFN-γ and IL-2 were positively correlated with TI/TE and VT, whereas negatively correlated with RR; IL-4 and IL-6 were negatively correlated with TI/TE and VT, and positively correlated with RR (P<0.05). After adjusting for confounding factors, IFN-γ, IL-2, IL-4, and IL-6 were associated with the efficacy of treatment in children with human metapneumovirus pneumonia (P<0.05). The combined prediction of IFN-γ, IL-2, IL-4, and IL-6 for the efficacy of treatment in children with human metapneumovirus pneumonia was superior to that of individual indicators (AUC: 0.927, 0.805, 0.791, 0.789, 0.777). Conclusion IFN-γ, IL-2, IL-4, and IL-6 are influencing factors for the therapeutic efficacy in children with human metapneumovirus pneumonia, and are closely associated with lung function indicators. They can be used jointly to predict the therapeutic efficacy efficacy and help guide clinical diagnosis and treatment.

Key words: Human metapneumovirus, Pneumonia, Th1/Th2 cytokines, Treatment efficacy

中图分类号:

R511
R563.1

孙伟, 安淑华, 周建伟, 董伟然, 闫智慧, 田利远. Th1/Th2细胞因子在人偏肺病毒肺炎患儿疗效评价中的作用[J]. 新发传染病电子杂志, 2025, 10(5): 17-21.

Sun Wei, An Shuhua, Zhou Jianwei, Dong Weiran, Yan Zhihui, Tian Liyuan. Role of Th1/Th2 cytokines in the efficacy evaluation of pediatric patients with human metapneumovirus pneumonia[J]. Electronic Journal of Emerging Infectious Diseases, 2025, 10(5): 17-21.

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