| BackgroundSyphilis is a chronic disease caused by sexually transmitted treponema pallidum.As a classic sexually transmitted disease,the incidence of syphilis has been on the rise in recent years.Because of the complicated immunological changes of syphilis,the prevention and treatment of the disease is difficult.In order to better control syphilis,it is necessary to conduct in-depth and systematic research on the immunological changes of the disease.To understand the status of the immunology syphilis patients with different lesion period dynamic evolution,to explore the causes of syphilis patients with disease progression and transformation and the possible mechanism,especially the different pathological changes of cellular immune function in patients with syphilis change and abnormal immune function caused by changes in the level of cytokine,in order to develop more effective prevention and control measures.ObjectiveComparing the differences between the levels of exomen blood lymphocytes and cytokines in patients with syphilis during different lesions,and further analyzing the clinical significance of changes in the level of exostatic blood lymphocytes and cytokines.MethodsThe relevant data of 114 patients with syphilis(observation group)who were admitted to the hospital between January 2016 and July 2020as well as 114 healthy people(control group)who underwent physical examination in the hospital were retrospectively analyzed.Patients in the observation group were divided into the first-stage group(n=44),the second-stage group(n=38)and the third-stage group(n=32)according to the pathological stage.Flow cytometry was used to determine the levels of peripheral blood lymphocytes(CD3~+,CD4~+and CD8~+T cells),and enzyme-linked immunosorbent assay was used to determine levels of peripheral blood lymphocytes associated cytokines(IFN-γ,IL-10).The levels of CD3~+,CD4~+,CD8~+T cells,IFN-γand IL-10 were compared among groups,and the correlation between above indicators and the pathological stage was analyzed by Pearman correlatio analysis.The evaluation value of above indicators for pathological stages of patients with syphilis was judged by ROC curve.Results1.The levels of CD3~+and CD4~+T cells in the observation group in different pathological stages were significantly lower than those in the control group,while the level of CD8~+T cells were significantly higher than the control group(P<0.05).The levels of CD3~+and CD4~+T cells decreased with the increase of the pathological stage,while the level of CD8~+T cells increased with the pathological stage(P<0.05).Peripheral lymphocytes CD3~+and CD4~+T cells were negatively correlated with the pathological stage(r=-0.728,-0.715;P<0.05),while CD8~+T cells were positively correlated with the pathological stage(r=0.683;P<0.05).The best cutoff values of CD3~+T cells for evaluating syphilis in the first,second and third stages were 67.96%,61.61%and 55.68%,and the AUC were 0.528,0.746 and 0.971,respectively.The evaluation value for the third phase was the best,and the sensitivity and specificity(93.8%and 93.9%)were higher than the first and second stages.The best cutoff values of CD4~+T cells for evaluating syphilis in the first,second and third stages were 41.56%,37.75%and 32.04%,and the AUC were0.542,0.790,and 0.960,respectively.The evaluation value for the third stage was the best,and the sensitivity and specificity(100.0%and 90.3%)were higher than the first and second stages.The best cutoff values of CD8~+T cells for evaluating syphilis in the first,second and third stages were 27.42%,31.11%and 36.23%,and the AUC were 0.617,0.773,and 0.967,respectively.The evaluation value for the third stage was the best,and the sensitivity and specificity(90.6%and 92.6%)were higher than the first and second stages.2.The IFN-γand IL-10 levels in the observation group in different pathological stages were significantly higher than those in the control group(P<0.05).The trend of IFN-γand IL-10 levels in different stages was as follows:first-stage group,second-stage group,third-stage group,with significant differences among groups(P<0.05).IFN-γand IL-10 were positively correlated with the pathological stage(r=0.799,0.694,P<0.05).The optimal cut-off values of IFN-γfor evaluating syphilis in the first,second and third stages were were 18.35pg/m L,22.31pg/m L and 25.77pg/m L,and the AUC were 0.6132,0.825 and0.975,respectively.The evaluation value for the third phase was the best,with sensitivity and specificity of 97.9%and 89.3%,higher than the first and second stages.The best cutoff value of IL-10 for evaluating syphilis in the first,second and third stages were 47.29pg/m L,52.24pg/m L and 57.23pg/m L,and the AUC were 0.546,0.713 and 0.969,respectively.The evaluation value for the third phase was the best,and the sensitivity and specificity(93.8%and 91.8%)were higher than the first and second stages.ConclusionThe number of abnormal weekly lymphocytes in patients with syphilis in different lesions periods,CD3~+,CD4~+-T lymphocytes decreased,CD8~+-T levels increased,and the level of related cytokines IFN-γand IL-10 increased,and the degree of abnormal change was related to the stage of lesions.This study can provide some value for the phased evaluation of lesions in clinical syphilis patients. |
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