Th17/Treg平衡与男性无症状高尿酸血症相关性研究及痛风风险评估-现代医学

Th17/Treg平衡与男性无症状高尿酸血症相关性研究及痛风风险评估

单位：1. 山西医科大学汾阳学院, 山西汾阳 032200;
2. 山西医科大学附属汾阳医院风湿免疫科, 山西汾阳 032200

分类号：R593

出版年·卷·期（页码）：2025·53·第五期（732-737）

摘要：

目的： 探讨辅助性T细胞17(Th17)/调节性T细胞(Treg)平衡在无症状高尿酸血症(aHUA)中的作用及其对痛风的预测价值。方法： 于山西医科大学附属汾阳医院体检中心数据库招募符合纳入排除标准的67例aHUA患者、79例健康对照组(HCs)，收集基本信息、体检数据，检测实验室指标、外周血CD4⁺T淋巴细胞亚群，aHUA组随访6个月观察关节病变，双源CT检查受累关节尿酸盐晶体形成情况。采用SPSS 27.0统计软件分析，采用t检验、非参数检验、卡方检验进行组间临床资料与CD4⁺T淋巴细胞亚群比较，采用Logistic回归分析aHUA进展为痛风的影响因素。结果： aHUA组外周血Th17细胞计数[10.51(9.01,15.47)]较HCs组[8.71(6.17,12.28)]明显增高，差异有统计学意义(P＜0.05)； aHUA组的Th17/Treg[0.38(0.33,0.48)]与HCs组[0.29(0.21,0.37)]比较明显增高，差异有统计学意义(P＜0.05)。Th17细胞(OR=1.382，95%CI 1.037～1.841，P=0.027)、尿酸(OR=1.020，95%CI 1.005～1.036，P=0.008)是aHUA发展为痛风的危险因素。结论： aHUA患者外周血Th17细胞、Th17/Treg较健康人升高，且Th17细胞、UA是aHUA发展为痛风的危险因素。

Objective: To investigate the role of the T helper 17(Th17)/regulatory T cell(Treg) balance in asymptomatic hyperuricemia(aHUA) and its predictive value for the progression to gout arthrolithiasis. Methods: A total of 67 aHUA patients and 79 healthy controls(HCs) meeting inclusion/exclusion criteria were recruited from the physical examination database of Shanxi Medical University Affiliated Fenyang Hospital. Demographic information, physical examination data, laboratory parameters, and peripheral blood CD4⁺ T lymphocyte subsets were collected. The aHUA group was followed for 6 months to observe joint lesions, and dual-source CT of affected joints was used for examining monosodium urate deposition. Statistical analysis was performed by SPSS 27.0. Independent t-tests, non-parametric tests, and chi-square tests were used to compare clinical data and CD4⁺ T lymphocyte subsets between two groups. Logistic regression analysis was applied to identify factors influencing the progression from aHUA to gout arthrolithiasis. Results: The peripheral Th17 cell count in the aHUA group[10.51(9.01, 15.47)] was significantly higher than that in the HCs group[8.71(6.17, 12.28)](P<0.05). The Th17/Treg ratio in the aHUA group[0.38(0.33, 0.48)] was also significantly elevated compared to the HCs group[0.29(0.21, 0.37)](P<0.05). Th17 cells(OR=1.382，95%CI 1.037-1.841，P=0.027) and uric acid(OR=1.020，95%CI 1.005-1.036，P=0.008) were identified as risk factors for the progression of aHUA to gout arthrolithiasis. Conclusion: Th17 cells and Th17/Treg in peripheral blood of aHUA patients were higher than those of healthy people, and Th17 cells and uric acid were independent risk factors for predicting the development of gout arthrolithiasis in aHUA patients.

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