| 杨丹,热娜·买买提.孤独症谱系障碍患儿血浆炎症因子IL-6、TNF-α与S100B水平的变化及其临床意义[J].安徽医药,待发表. |
| 孤独症谱系障碍患儿血浆炎症因子IL-6、TNF-α与S100B水平的变化及其临床意义 |
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| 投稿时间：2025-03-11 录用日期：2025-05-14 |
| DOI： |
| 中文关键词: 孤独症谱系障碍 白细胞介素-6 肿瘤坏死因子-α S100B蛋白 |
| 英文关键词: |
| 基金项目:新疆维吾尔自治区儿童重大疾病大数据平台与一体化防诊治体系建立(2024B03038-2) |
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| 中文摘要: |
| 目的 通过孤独症谱系障碍（ASD）儿童与健康儿童两组外周血TH17细胞比例及血浆中炎症因子IL-6、TNF-α及神经损伤标志物S100B的表达水平差异比较，分析其与ASD患儿临床症状严重程度及预后的相关性，并探讨ASD患儿免疫功能与胶质细胞潜在联系。方法 将2024年6月～2024年12月期间就诊于乌鲁木齐市某三甲医院儿童保健科门诊就诊的3～8岁ASD患儿53 例作为研究对象（ASD组），同期另选取同期儿童保健科接诊的健康体检儿童77例作为对照组，年龄、性别与ASD组均衡可比。对比组间外周血TH17细胞比例及血浆S100B、IL-6、TNF-α水平差异；采用Pearson相关分析法评估血浆S100B、IL-6及TNF-α水平与CARS评分的相关性；通过受试者工作特性（ROC）曲线分析，进一步探讨S100B、IL-6及TNF-α对孤独症谱系障碍（ASD）患儿病情进展及预后的预测效能。结果 ASD 组患儿一般资料与健康对照组相比差异无统计学意义(P＞0.05)。与正常组比较，ASD儿童Th17 细胞比例显著升高（分别为0.72±0.15%、2.20±0.45%），差异有统计学意义（P<0.001)；ASD组患儿血浆S100B、IL-6、TNF-α水平均明显高于健康对照组(t值分别为17.10、18.86、21.58，均P＜0.05)。重度组患儿血浆S100B、IL-6、TNF-α水平均明显高于轻中度组(t值分别为4.500、6.247、5.510，均 P＜0.05)。Pearson相关分析结果表明，ASD患儿血浆中S100B、IL-6及TNF-α水平与CARS评分均呈显著正相关（r值分别为0.567、0.819、0.678，P值均＜0.05）。ROC曲线结果显示，血浆S100B、IL-6、TNF-α预测ASD病情发展曲线下面积(AUC)(95％CI)分别为0.806(0.654-0.959)、0.850(0.700-0.999)、0.879（0.756-0.999）,截断值分别为234.92pg/mL、12.08pg/mL、68.98pg/mL，特异度分别为 81.20％、87.50％、81.20%,灵敏度为66.70％、80.00%、86.70%；三者联合预测的AUC(95％CI)为0.992(0.970-0.999),特异度为94.00％,灵敏度为99.99％。结论 ASD患儿外周血TH17细胞比例较健康儿童升高说明存在免疫失衡。血浆S100B、IL-6、TNF-α水平在ASD患儿中表达上调，且与病情严重程度密切相关,有望作为评估ASD病情发展及预后的潜在外周血标记物。 |
| 英文摘要: |
| Objective Through the difference in the proportion of TH17 cells in peripheral blood and the expression levels of inflammatory cytokines IL-6, TNF-α and nerve damage marker S100B in plasma between children with autism spectrum disorder (ASD) and healthy children, the correlation between them and the severity of clinical symptoms and prognosis of children with ASD was analyzed, and the potential relationship between immune function and glial cells in children with ASD was also explored.Methods From June 2024 to December 2024, 53 children with ASD aged 3 to 8 years old who were admitted to the Child Health Care Department of a top-three hospital in Urumqi were selected as the study subjects (ASD group), and 77 healthy children with age and gender matching were selected as the control group during the same period. The proportion of TH17 cells in peripheral blood and plasma levels of S100B, IL-6 ,TNF-α were compared between groups. Pearson correlation analysis was used to investigate the relationship between plasma S100B, IL-6, TNF-α and CARS score. The predictive value of S100B, IL-6 and TNF-α in the development and prognosis of ASD was evaluated by receiver operating characteristic (ROC) curve. Results There was no significant difference between the ASD group and the healthy control group (P > 0.05).The proportion of Th17 cells in children with ASD was significantly increased(0.72±0.15% and 2.20±0.45%, respectively) with statistical significance (P<0.001). Plasma levels of S100B, IL-6 and TNF-α in ASD group were significantly higher than those in healthy control group (t values were 17.10, 18.86 and 21.58, respectively, P < 0.05). Plasma levels of S100B, IL-6 and TNF-α in severe group were significantly higher than those in mild to moderate group (t values were 4.500, 6.247 and 5.510, respectively, all P < 0.05). Pearson correlation analysis showed that plasma levels of S100B, IL-6 and TNF-α were positively correlated with CARS scores in ASD children (r values were 0.567, 0.819 and 0.678, respectively, all P < 0.05). ROC curve results show that, The area under the curve (AUC)(95%CI) of plasma S100B, IL-6 and TNF-α were 0.806(0.654 to 0.959), 0.850(0.756 to 0.999) and 0.879 (0.756 to 0.999), respectively, and the cutoff values were 234.92pg/m, respectively L, 12.08pg/mL, 68.98pg/mL, the specificity was 81.20%, 87.50%, 81.20%, the sensitivity was 66.70%, 80.00%, 86.70%; The AUC(95% CI) predicted by the three was 0.992(0.970-0.999), the specificity was 94%, and the sensitivity was 99.99%. Conclusion The proportion of TH17 cells in peripheral blood of children with ASD is higher than that of healthy children, indicating immune imbalance.The levels of plasma S100B, IL-6 and TNF-α are up-regulated in children with ASD, and are closely related to the severity of the disease, which may be used as potential peripheral blood markers to evaluate the development and prognosis of ASD. |
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