中华消化外科杂志
中華消化外科雜誌
중화소화외과잡지
CHINESE JOURNAL OF DIGESTIVE SURGERY
2014年
10期
811-815
,共5页
马海长%吐尔洪江·吐逊%张恒%张雪%刘清%杨乐%林仁勇%温浩
馬海長%吐爾洪江·吐遜%張恆%張雪%劉清%楊樂%林仁勇%溫浩
마해장%토이홍강·토손%장항%장설%류청%양악%림인용%온호
肝泡型包虫病%T细胞%转录因子%免疫逃避
肝泡型包蟲病%T細胞%轉錄因子%免疫逃避
간포형포충병%T세포%전록인자%면역도피
Hepatic alveolar echinococcosis%T cells%Transcription factor%Immune evasion
目的 探讨阿苯达唑对肝泡型包虫病患者外周血单个核细胞中转录因子T-bet和GATA3mRNA表达的影响及意义.方法 回顾性分析2013年4月至11月新疆医科大学第一附属医院收治的55例受试者的临床资料.其中肝泡型包虫病患者服用阿苯达唑15例,纳入药物组;肝泡型包虫病首治患者14例,纳入肝泡型包虫病组;健康志愿者26例,纳入健康志愿者组.药物组患者口服片剂阿苯达唑10 mg/(kg ·d),用药时间为(2.5±2.3)年.所有受试者在入组后第2天清晨空腹抽取外周血.采用实时荧光定量PCR法检测各组受试者外周血单个核细胞T-bet和GATA3 mRNA的表达,同时运用ELISA法检测受试者血浆IFN-γ、IL-5的表达.正态分布数据以(x)±s表示,偏态分布数据以M表示,组间比较用单因素方差分析,两两比较采用LSD-t法,用直线相关分析探讨两因素之间相关关系.结果 药物组、肝泡型包虫病组和健康志愿者组受试者外周血单个核细胞T-bet mRNA中位值分别为0.117、0.114、0.094,3组比较,差异无统计学意义(F =0.34,P>0.05);药物组、肝泡型包虫病组和健康志愿者组受试者外周血单个核细胞GATA3mRNA表达水平中位值分别为0.006、0.007、0.021,3组比较,差异有统计学意义(F =4.96,P<0.05);药物组、健康志愿者组和肝泡型包虫病组受试者T-bet与GATA3的比值(T-bet/GATA3)中位值分别为25.618、8.235、4.350,3组比较,差异有统计学意义(F=9.12,P<0.05).药物组、肝泡型包虫病组和健康志愿者组受试者血浆IFN-γ表达水平分别为(367±252) μg/L、(305±52) μg/L、(326±122) μg/L,3组比较,差异无统计学意义(F=0.52,P>0.05);药物组、肝泡型包虫病组和健康志愿者组受试者血浆IL-5表达水平分别为(40±8)μg/L、(52±39) μg/L、(41±6)μg/L,3组比较,差异无统计学意义(F=1.85,P>0.05);药物组、健康志愿者组和肝泡型包虫病组受试者IFN-γ与IL-5的比值分别为9.5±9.2、6.8±2.1、8.0±2.8,3组比较,差异无统计学意义(F=1.18,P>0.05).药物组患者阿苯达唑用药时间和T-bet/GATA3之间无相关性(r=0.076,P>0.05).结论 肝泡型包虫病患者口服阿苯达唑后明显上调T-bet/GATA3,逆转Th1/Th2细胞失衡,Th1细胞杀伤多房棘球蚴的能力明显增强,而Th2细胞保护多房棘球蚴的能力有所减弱.机体的保护性免疫应答有所恢复.外周血T-bet/GATA3可作为阿苯达唑治疗肝泡型包虫病疗效评价的随访指标.
目的 探討阿苯達唑對肝泡型包蟲病患者外週血單箇覈細胞中轉錄因子T-bet和GATA3mRNA錶達的影響及意義.方法 迴顧性分析2013年4月至11月新疆醫科大學第一附屬醫院收治的55例受試者的臨床資料.其中肝泡型包蟲病患者服用阿苯達唑15例,納入藥物組;肝泡型包蟲病首治患者14例,納入肝泡型包蟲病組;健康誌願者26例,納入健康誌願者組.藥物組患者口服片劑阿苯達唑10 mg/(kg ·d),用藥時間為(2.5±2.3)年.所有受試者在入組後第2天清晨空腹抽取外週血.採用實時熒光定量PCR法檢測各組受試者外週血單箇覈細胞T-bet和GATA3 mRNA的錶達,同時運用ELISA法檢測受試者血漿IFN-γ、IL-5的錶達.正態分佈數據以(x)±s錶示,偏態分佈數據以M錶示,組間比較用單因素方差分析,兩兩比較採用LSD-t法,用直線相關分析探討兩因素之間相關關繫.結果 藥物組、肝泡型包蟲病組和健康誌願者組受試者外週血單箇覈細胞T-bet mRNA中位值分彆為0.117、0.114、0.094,3組比較,差異無統計學意義(F =0.34,P>0.05);藥物組、肝泡型包蟲病組和健康誌願者組受試者外週血單箇覈細胞GATA3mRNA錶達水平中位值分彆為0.006、0.007、0.021,3組比較,差異有統計學意義(F =4.96,P<0.05);藥物組、健康誌願者組和肝泡型包蟲病組受試者T-bet與GATA3的比值(T-bet/GATA3)中位值分彆為25.618、8.235、4.350,3組比較,差異有統計學意義(F=9.12,P<0.05).藥物組、肝泡型包蟲病組和健康誌願者組受試者血漿IFN-γ錶達水平分彆為(367±252) μg/L、(305±52) μg/L、(326±122) μg/L,3組比較,差異無統計學意義(F=0.52,P>0.05);藥物組、肝泡型包蟲病組和健康誌願者組受試者血漿IL-5錶達水平分彆為(40±8)μg/L、(52±39) μg/L、(41±6)μg/L,3組比較,差異無統計學意義(F=1.85,P>0.05);藥物組、健康誌願者組和肝泡型包蟲病組受試者IFN-γ與IL-5的比值分彆為9.5±9.2、6.8±2.1、8.0±2.8,3組比較,差異無統計學意義(F=1.18,P>0.05).藥物組患者阿苯達唑用藥時間和T-bet/GATA3之間無相關性(r=0.076,P>0.05).結論 肝泡型包蟲病患者口服阿苯達唑後明顯上調T-bet/GATA3,逆轉Th1/Th2細胞失衡,Th1細胞殺傷多房棘毬蚴的能力明顯增彊,而Th2細胞保護多房棘毬蚴的能力有所減弱.機體的保護性免疫應答有所恢複.外週血T-bet/GATA3可作為阿苯達唑治療肝泡型包蟲病療效評價的隨訪指標.
목적 탐토아분체서대간포형포충병환자외주혈단개핵세포중전록인자T-bet화GATA3mRNA표체적영향급의의.방법 회고성분석2013년4월지11월신강의과대학제일부속의원수치적55례수시자적림상자료.기중간포형포충병환자복용아분체서15례,납입약물조;간포형포충병수치환자14례,납입간포형포충병조;건강지원자26례,납입건강지원자조.약물조환자구복편제아분체서10 mg/(kg ·d),용약시간위(2.5±2.3)년.소유수시자재입조후제2천청신공복추취외주혈.채용실시형광정량PCR법검측각조수시자외주혈단개핵세포T-bet화GATA3 mRNA적표체,동시운용ELISA법검측수시자혈장IFN-γ、IL-5적표체.정태분포수거이(x)±s표시,편태분포수거이M표시,조간비교용단인소방차분석,량량비교채용LSD-t법,용직선상관분석탐토량인소지간상관관계.결과 약물조、간포형포충병조화건강지원자조수시자외주혈단개핵세포T-bet mRNA중위치분별위0.117、0.114、0.094,3조비교,차이무통계학의의(F =0.34,P>0.05);약물조、간포형포충병조화건강지원자조수시자외주혈단개핵세포GATA3mRNA표체수평중위치분별위0.006、0.007、0.021,3조비교,차이유통계학의의(F =4.96,P<0.05);약물조、건강지원자조화간포형포충병조수시자T-bet여GATA3적비치(T-bet/GATA3)중위치분별위25.618、8.235、4.350,3조비교,차이유통계학의의(F=9.12,P<0.05).약물조、간포형포충병조화건강지원자조수시자혈장IFN-γ표체수평분별위(367±252) μg/L、(305±52) μg/L、(326±122) μg/L,3조비교,차이무통계학의의(F=0.52,P>0.05);약물조、간포형포충병조화건강지원자조수시자혈장IL-5표체수평분별위(40±8)μg/L、(52±39) μg/L、(41±6)μg/L,3조비교,차이무통계학의의(F=1.85,P>0.05);약물조、건강지원자조화간포형포충병조수시자IFN-γ여IL-5적비치분별위9.5±9.2、6.8±2.1、8.0±2.8,3조비교,차이무통계학의의(F=1.18,P>0.05).약물조환자아분체서용약시간화T-bet/GATA3지간무상관성(r=0.076,P>0.05).결론 간포형포충병환자구복아분체서후명현상조T-bet/GATA3,역전Th1/Th2세포실형,Th1세포살상다방극구유적능력명현증강,이Th2세포보호다방극구유적능력유소감약.궤체적보호성면역응답유소회복.외주혈T-bet/GATA3가작위아분체서치료간포형포충병료효평개적수방지표.
Objective To investigate the influence of Albendazole (ABZ) on the expression of T-bet and GATA3 mRNA of peripheral blood mononuclear cells in patients with hepatic alveolar echinococcosis (HAE) and its significance.Methods The clinical data of 55 individuals in the First Affiliated Hospital of Xinjiang Medical University from April to November 2013 were retrospectively analyzed.Fifteen patients with HAE who received ABZ orally were in the HAE + ABZ group,15 patients with HAE were in the HAE group,and 26 healthy individuals were in the healthy donor group.ABZ was administered with dosage of 10 mg/(kg · d) for (2.5 ± 2.3)years.The peripheral blood was drawn at the second day.The mRNA expressions of T-bet and GATA3 in the peripheral mononuclear cells were detected by real-time PCR.The plasma levels of interferon-γ (IFN-γ) and interleukin-5 (IL-5) were detected by enzyme linked immunosorbent assay (ELISA).Normal distribution data were presented by (x) ± s and skewed distribution data were presonted by M.Data were analyzed using the analysis of variance or LSD-t test,and the correlation of 2 factors was analyzed using the linear correlation analysis.Results The median value of the expression of T-bet in the HAE + ABZ group,the HAE group and the healthy donor group were 0.117,0.114,0.094,with no significant difference between the 3 groups (F =0.34,P > 0.05).The median value of the expressions of the GATA3 in the HAE + ABZ group,the HAE group and the healthy donor group were 0.006,0.007,0.021,with significant difference between the 3 groups (F =4.96,P < 0.05).The median value of the ratios of T-bet to GATA3 in the HAE + ABZ group,the HAE group and the healthy donor group were 25.618,8.235,4.350,with significant difference between the 3 groups (F =9.12,P <0.05).The expressions of IFN-γ in the HAE + ABZ group,the HAE group and the healthy donor group were (367 ± 252) μg/L,(305 ± 52)μg/L and (326 ± 122) μg/L,with no significant difference between the 3 groups (F =0.52,P > 0.05).The expressions of IL-5 in the HAE + ABZ group,the HAE group and the healthy donor group were (40 ± 8)μg/L,(52 ±39)μg/L and (41 ±6)μg/L,with no significant difference between the 3 groups (F =1.85,P >0.05).The ratios of IFN-γto IL-5 in the HAE + ABZ group,the HAE group and the healthy donor group were 9.5 ± 9.2,6.8 ±2.1 and 8.0 ± 2.8,with no significantly difference between the 3 groups (F =1.18,P > 0.05).There was no correlation between the administration time of ABZ and the ratio of T-bet to GATA3 in the HAE + ABZ group (r =0.076,P > 0.05).Conclusions The ratio of T-bet to GATA3 is significantly increased after administration of ABZ,and the Th1/Th2 immune response is skewed towards Th1 cells to enhance the parasite elimination,and thus the Th2 cells response is weakened.The ratio of T-bet to GATA3 may be the indicator for evaluating the efficacy of ABZ in the treatment of HAZ.