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目的:探讨急性重症胆囊炎患者血浆高迁移率族蛋白B1（HMGB1）及辅助性T细胞17（Th17）、调节性T细胞（Treg）水平变化及相关性。方法:选择浙江新安国际医院2017年1月至2018年12月诊治的急性重症胆囊炎患者120例（胆囊炎组）和同期健康体检者120例（对照组）作为研究对象。采用酶联免疫吸附试验法测定两组HMGB1、白细胞介素（IL）-17、转化生长因子（TGF）-β水平；采用流式细胞术测定两组Th17和Treg细胞水平，并进行比较；胆囊炎组患者均行经皮经肝胆囊穿刺联合腹腔镜手术治疗，比较治疗前后上述指标的变化。结果:胆囊炎组HMGB1和Th17细胞水平高于对照组，Treg细胞水平低于对照组[（9.84 ± 0.82）μg/L比（4.12 ± 0.75）μg/L、（4.02 ± 0.31）%比（1.53 ± 0.24）%、（3.16 ± 0.65）%比（6.17 ± 0.73）%]，差异均有统计学意义（n P<0.01）。胆囊炎组IL-17细胞水平高于对照组，TGF-β水平低于对照组[（37.46 ± 4.73）ng/L比（18.52 ± 4.32）ng/L、（4.32 ± 0.64）μg/L比（6.84 ± 0.67）μg/L]，差异均有统计学意义（n P<0.01）。急性重症胆囊炎患者血清HMGB1水平与Th17（n r=0.564）、IL-17（n r=0.602）水平呈正相关（n P<0.01），与Treg（n r=- 0.518）、TGF-β（n r=- 0.563）水平呈负相关（n P<0.01）。急性重症胆囊炎患者治疗后HMGB1、Th17、IL-17水平降低，Treg、TGF-β水平升高[（4.76 ± 0.75）μg/L比（9.84 ± 0.82）μg/L、（1.82 ± 0.24）%比（4.02 ± 0.31）%、（16.27 ± 4.28）ng/L比（37.46 ± 4.73）ng/L、（5.58 ± 0.73）%比（3.16 ± 0.65）%、（5.23 ± 0.55）μg/L比（4.32 ± 0.64）μg/L]，与治疗前比较差异均有统计学意义（n P<0.01）。n 结论:急性重症胆囊炎患者外周血HMGB1水平升高，Th17/Treg平衡失调，检测HMGB1、Th17和Treg细胞及其相关因子水平可反映机体炎性反应程度和治疗效果。“,”Objective:To investigate the levels of plasma high mobility group protein B1 (HMGB1), helper T cell 17 (Th17) and regulatory T cell (Treg) in patients with acute severe cholecystitis and its correlation.Methods:One hundred and twenty patients with acute severe cholecystitis were selected as the cholecystitis group, and 120 healthy subjects during the same period were selected as the control group from January 2017 to December 2018 in Zhejiang Xin′an International Hospital. Enzymelinked immunosorbent assay was used to determine the levels of HMGB1, interleukin (IL)-17 and transforming growth factor-β (TGF-β). Flow cytometry was used to determine Th17 and Treg cell levels. The patients in cholecystitis group received percutaneous transhepatic cholecystectomy combined with laparoscopic surgery, and the levels of above mentioned were detected and compared.Results:The levels of HMGB1 and Th17 cells in the cholecystitis group were higher than those in the control group, the level of Treg cells was lower than that in the control group [(9.84 ± 0.82) μg/L vs. (4.12 ± 0.75) μg/L, (4.02 ± 0.31)% vs. (1.53 ± 0.24)%, (3.16 ± 0.65)% vs. (6.17 ± 0.73)%], and the differences were statistically significant ( n P<0.01). The level of IL-17 in the cholecystitis group was higher than that in the control group, the level of TGF-β was lower than that in the control group [(37.46 ± 4.73) ng/L vs. (18.52 ± 4.32) ng/L, (4.32 ± 0.64) μg/L vs. (6.84 ± 0.67) μg/L], and the differences were statistically significant (n P<0.01). The serum HMGB1 level in patients with acute severe cholecystitis was positively correlated with Th17(n r=0.564) and IL-17(n r=0.602), was negatively correlated with Treg (n r=- 0.518) and TGF-β(n r=- 0.563), and the differences were statistically significant (n P<0.01). In the cholecystitis group, after treatment the levels of HMGB1, Th17, IL-17 were decreased [(4.76 ± 0.75) μg/L vs. (9.84 ± 0.82) μg/L, (1.82 ± 0.24)% vs. (4.02 ± 0.31)%,(16.27 ± 4.28) ng/L vs. (37.46 ± 4.73) ng/L], the levels of Treg, TGF-β were increased [(5.58 ± 0.73)% vs. (3.16 ± 0.65)%, (5.23 ± 0.55) μg/L vs. (4.32 ± 0.64) μg/L], and the differences were statistically significant (n P<0.01).n Conclusions:Patients with acute severe cholecystitis have elevated levels of HMGB1 and Th17 in plasma and have decreased levels of Treg. The levels of HMGB1, Th17 and Treg cells can reflect the therapeutic effect. HMGB1 is closely related to the imbalance of Th17/Treg.