传染病信息
傳染病信息
전염병신식
INFECTIOUS DISEASE INFORMATION
2013年
6期
343-347,357
,共6页
李晨%刘鸿凌%臧红%朱冰%陈婧%刘婉姝%游绍莉%辛绍杰
李晨%劉鴻凌%臧紅%硃冰%陳婧%劉婉姝%遊紹莉%辛紹傑
리신%류홍릉%장홍%주빙%진청%류완주%유소리%신소걸
乙型肝炎病毒%肝功能衰竭,急性%髓
乙型肝炎病毒%肝功能衰竭,急性%髓
을형간염병독%간공능쇠갈,급성%수
hepatitis B virus%liver failure,acute%marrow
目的：探讨外周血髓源性抑制细胞（myeloid-derived suppressor cells , MDSCs）在HBV相关慢加急性肝衰竭（HBV-related acute-on-chronic liver failure, HBV-ACLF）患者疾病进程中的临床意义。方法入组45例HBV-ACLF患者、34例慢性乙型肝炎（chronic hepatitis B, CHB）患者和25例健康对照者（healthy controls, HC），采用流式细胞仪检测外周血MDSCs频率。对HBV-ACLF患者进行为期3周的随访，根据临床疗效分为好转组和无效组，动态观察2组患者外周血MDSCs的频率变化。结果 HBV-ACLF组外周血MDSCs频率（1.53%±1.15%）高于CHB组（0.92%±0.46%）和HC组（0.91%±0.47%）（P均<0.01）。 HBV-ACLF组外周血MDSCs频率分别与TBIL、CRE、国际标准化比值（international normalized ratio, INR）、终末期肝病模型（model for end-stage liver disease, MELD）分值和MELD-Na分值呈正相关（r=0.434，P=0.003；r=0.343，P=0.021；r=0.505， P=0.000；r=0.528，P=0.000；r=0.451，P=0.002），其中与INR和TBIL成多元线性关系，回归模型为=-0.781+0.623×INR+0.003× TBIL。3周内死亡的HBV-ACLF组患者基线外周血MDSCs频率（2.09%±1.51%）高于好转组（1.15%±0.56%）和无效组（1.17%±0.70%）（P<0.05）。外周血MDSCs频率与患者整体预后存在较弱的等级相关（r=0.309，P=0.039）。随访显示好转组和无效组患者外周血MDSCs频率均无明显变化。结论 HBV-ACLF患者外周血MDSCs频率显著升高；其与预后存在相关性，外周血MDSCs频率过高的患者预后差。
目的：探討外週血髓源性抑製細胞（myeloid-derived suppressor cells , MDSCs）在HBV相關慢加急性肝衰竭（HBV-related acute-on-chronic liver failure, HBV-ACLF）患者疾病進程中的臨床意義。方法入組45例HBV-ACLF患者、34例慢性乙型肝炎（chronic hepatitis B, CHB）患者和25例健康對照者（healthy controls, HC），採用流式細胞儀檢測外週血MDSCs頻率。對HBV-ACLF患者進行為期3週的隨訪，根據臨床療效分為好轉組和無效組，動態觀察2組患者外週血MDSCs的頻率變化。結果 HBV-ACLF組外週血MDSCs頻率（1.53%±1.15%）高于CHB組（0.92%±0.46%）和HC組（0.91%±0.47%）（P均<0.01）。 HBV-ACLF組外週血MDSCs頻率分彆與TBIL、CRE、國際標準化比值（international normalized ratio, INR）、終末期肝病模型（model for end-stage liver disease, MELD）分值和MELD-Na分值呈正相關（r=0.434，P=0.003；r=0.343，P=0.021；r=0.505， P=0.000；r=0.528，P=0.000；r=0.451，P=0.002），其中與INR和TBIL成多元線性關繫，迴歸模型為=-0.781+0.623×INR+0.003× TBIL。3週內死亡的HBV-ACLF組患者基線外週血MDSCs頻率（2.09%±1.51%）高于好轉組（1.15%±0.56%）和無效組（1.17%±0.70%）（P<0.05）。外週血MDSCs頻率與患者整體預後存在較弱的等級相關（r=0.309，P=0.039）。隨訪顯示好轉組和無效組患者外週血MDSCs頻率均無明顯變化。結論 HBV-ACLF患者外週血MDSCs頻率顯著升高；其與預後存在相關性，外週血MDSCs頻率過高的患者預後差。
목적：탐토외주혈수원성억제세포（myeloid-derived suppressor cells , MDSCs）재HBV상관만가급성간쇠갈（HBV-related acute-on-chronic liver failure, HBV-ACLF）환자질병진정중적림상의의。방법입조45례HBV-ACLF환자、34례만성을형간염（chronic hepatitis B, CHB）환자화25례건강대조자（healthy controls, HC），채용류식세포의검측외주혈MDSCs빈솔。대HBV-ACLF환자진행위기3주적수방，근거림상료효분위호전조화무효조，동태관찰2조환자외주혈MDSCs적빈솔변화。결과 HBV-ACLF조외주혈MDSCs빈솔（1.53%±1.15%）고우CHB조（0.92%±0.46%）화HC조（0.91%±0.47%）（P균<0.01）。 HBV-ACLF조외주혈MDSCs빈솔분별여TBIL、CRE、국제표준화비치（international normalized ratio, INR）、종말기간병모형（model for end-stage liver disease, MELD）분치화MELD-Na분치정정상관（r=0.434，P=0.003；r=0.343，P=0.021；r=0.505， P=0.000；r=0.528，P=0.000；r=0.451，P=0.002），기중여INR화TBIL성다원선성관계，회귀모형위=-0.781+0.623×INR+0.003× TBIL。3주내사망적HBV-ACLF조환자기선외주혈MDSCs빈솔（2.09%±1.51%）고우호전조（1.15%±0.56%）화무효조（1.17%±0.70%）（P<0.05）。외주혈MDSCs빈솔여환자정체예후존재교약적등급상관（r=0.309，P=0.039）。수방현시호전조화무효조환자외주혈MDSCs빈솔균무명현변화。결론 HBV-ACLF환자외주혈MDSCs빈솔현저승고；기여예후존재상관성，외주혈MDSCs빈솔과고적환자예후차。
Objective To investigate clinical significance of myeloid-derived suppressor cells (MDSCs) in peripheral blood in the progression of HBV-related acute-on-chronic liver failure (HBV-ACLF). Methods Totally 45 HBV-ACLF patients, 34 pa-tients with chronic hepatitis B (CHB) and 25 healthy controls (HC) were enrolled in the study. Flow cytometry was applied to detect the frequencies of MDSCs in peripheral blood. HBV-ACLF patients were given a three-week follow-up, and were divided into an improved group and an ineffective group according to the clinical efficacy. The changes of the frequencies of MDSCs in peripheral blood in the improved group and the ineffective group were observed dynamically. Results The frequencies of MDSCs in peripheral blood in HBV-ACLF group (1.53%±1.15%) were significantly higher than those in CHB group (0.92%±0.46%) and those in HC group (0.91%±0.47%) (P<0.01). The frequency of MDSCs in peripheral blood in HBV-ACLF group was positively correlated with TBIL (r=0.434, P=0.003), CRE (r=0.343, P=0.021), international normalized ratio (INR) (r=0.505, P=0.000), model for end-stage liver disease (MELD) score (r=0.528, P=0.000) and MELD-Na score (r=0.451, P=0.002), and had a multiple linear relationship with INR and TBIL (the regression model: =-0.781+0.623 ×INR+0.003 ×TBIL). The HBV-ACLF patients who died within 3 weeks had higher frequencies of MDSCs in peripheral blood (2.09%±1.51%) than the improved group (1.15%±0.56%) and the ineffective group (1.17%±0.70%) (P<0.05). The frequencies of MDSCs in peripheral blood had a weak rank correlation with the prognosis of the pa-tients (r=0.309, P=0.039). The follow-up showed the frequencies of MDSCs in peripheral blood were not significantly different in the improved group and the ineffective group. Conclusions The frequency of MDSCs in peripheral blood in HBV-ACLF patients in-creases significantly. It is correlated with the prognosis of HBV-ACLF patients. The higher the frequency of MDSCs in peripheral blood is, the poorer prognosis the HBV-ACLF patients have.
