CAJ | 학술논문

目的探讨乙型肝炎病毒相关慢加急性肝衰竭(HBV-ACLF)患者外周血T淋巴细胞受体β链Ⅴ区(TCR Ⅴβ)亚家族的表达及其临床意义.方法选择兰州市第二人民医院2010年10月至2012年3月收治的HBV-ACLF患者28例(HBV-ACLF组),同时选取同期住院的慢性乙型肝炎急性发作(CHB-F)患者32例(CHB-F组)和20名健康体检者(健康对照组).采用RT-PCR检测TCR Ⅴβ亚家族水平,ELISA法检测血清中IL-2、IL-4、IL-6、IL-10、IFN-γ和TNF-α水平,对3组数据进行对比分析.3组间比较采用单因素方差分析,两组间均数比较用LSD-t检验,如不符合,则采用秩和检验.结果 3组间性别构成比和年龄比较差异均无统计学意义(均P＞0.05);HBV-ACLF组与CHB-F组TBil、Alb、PTA、国际标准化比值(INR)、总胆固醇(TC)差异均有统计学意义(均P＜0.05).HBV-ACLF组患者IL-2、IL-4、IL-10水平低于健康对照组(H值分别为14.061、31.681和31.380,均P=0.000),而IL-6、IFN-γ水平均高于健康对照组(H值分别为13.332和12.380,均P=0.000).CHB-F组IL-4、IL-10、TNF-α水平低于健康对照组(H值分别为21.152、18.401和10.002,均P=0.000);HBV-ACLF组IL-2、IL-10、TNF-α水平低于CHB-F组(H值分别为8.795、9.414和8.423,P值分别为0.003、0.002和0.004),而IL-6、IFN-γ水平高于CHB-F组(H值分别为5.889和7.534,P值分别为0.015和0.006).秩和检验分析显示,3组间△Ct1、△Ct5、△Ct7、△Ct12、△Ct15、△Ct20、△Ct22、△Ct23值差异均有统计学意义(H值分别为20.368、14.368、19.500、31.532、19.985、19.116、41.752和20.649,均P＜0.05).结论 HBV-ACLF患者体内TCR Ⅴβ部分亚家族以及细胞因子的表达水平发生了改变.
목적 탐토을형간염병독상관만가급성간쇠갈(HBV-ACLF)환자외주혈T림파세포수체β련Ⅴ구(TCR Ⅴβ)아가족적표체급기림상의의.방법 선택란주시제이인민의원2010년10월지2012년3월수치적HBV-ACLF환자28례(HBV-ACLF조),동시선취동기주원적만성을형간염급성발작(CHB-F)환자32례(CHB-F조)화20명건강체검자(건강대조조).채용RT-PCR검측TCR Ⅴβ아가족수평,ELISA법검측혈청중IL-2、IL-4、IL-6、IL-10、IFN-γ화TNF-α수평,대3조수거진행대비분석.3조간비교채용단인소방차분석,량조간균수비교용LSD-t검험,여불부합,칙채용질화검험.결과 3조간성별구성비화년령비교차이균무통계학의의(균P＞0.05);HBV-ACLF조여CHB-F조TBil、Alb、PTA、국제표준화비치(INR)、총담고순(TC)차이균유통계학의의(균P＜0.05).HBV-ACLF조환자IL-2、IL-4、IL-10수평저우건강대조조(H치분별위14.061、31.681화31.380,균P=0.000),이IL-6、IFN-γ수평균고우건강대조조(H치분별위13.332화12.380,균P=0.000).CHB-F조IL-4、IL-10、TNF-α수평저우건강대조조(H치분별위21.152、18.401화10.002,균P=0.000);HBV-ACLF조IL-2、IL-10、TNF-α수평저우CHB-F조(H치분별위8.795、9.414화8.423,P치분별위0.003、0.002화0.004),이IL-6、IFN-γ수평고우CHB-F조(H치분별위5.889화7.534,P치분별위0.015화0.006).질화검험분석현시,3조간△Ct1、△Ct5、△Ct7、△Ct12、△Ct15、△Ct20、△Ct22、△Ct23치차이균유통계학의의(H치분별위20.368、14.368、19.500、31.532、19.985、19.116、41.752화20.649,균P＜0.05).결론 HBV-ACLF환자체내TCR Ⅴβ부분아가족이급세포인자적표체수평발생료개변.
Objective To investigate the expression and clinical significance of T-cell receptor (TCR) Ⅴβ subfamily in hepatitis B virus (HBV)-related acute-on-chronic liver failure (HBV-ACLF) patients.Methods Twenty-eight patients with HBV-ACLF (HBV-ACLF group) and 32 patients with chronic hepatitis B flare (CHB-F group),who were treated in The Second People's Hospital from Oct.2010 to Mar.2012,and 20 healthy controls (HC group) were included in the study.Reverse transcriptase-polymerase chain reaction was used to detect the levels of TCR Ⅴβ subfamily and enzymelinked immunosorbent assay was used to detect the levels of serum cytokines [interleukin (IL)-2,IL-4,IL-6,IL-10,interferon (IFN)-γ and tumor necrosis factor (TNF)-α)] in the three groups.The comparison among three groups was done by one-way analysis of variance and the comparison between two groups was done by LSD-t test or rank sum test.Results The three groups had similar gender and age distribution (all P＞0.05).The HBV-ACLF group had significant different profiles of total bilirubin,albumin,prothrombin activity,international normalized ratio and cholesterol tatol compared with the CHB-F group (all P＜0.05).For patients in the HBV-ACLF group,the serum IL-2,IL-4,and IL-10 levels were lower(all P=0.000),and the IL-6 and IFN γ levels were higher than those of the HC group (all P=0.000).The IL-4,IL-10,and TNF-α levels in the CHB-F group were also significantly lower than those of the HC group (all P=0.000).Compared with the CHB-F group,the HBV-ACLF group had significantly lower IL-2,IL-10,and TNF-α levels (P=0.003,0.002,0.004),and higher IL-6 and IFN-γ levels (P=0.015,0.006).By one-way analysis of variance,there were significantly differences of △Ct1,△Ct5,△Ct7,△Ct12,△Ct15,△Ct20,△Ct22,and △Ct23 among the three groups (H=20.368,14.368,19.500,31.532,19.985,19.116,41.752 and 20.649,all P＜0.05).Conclusion The expression levels of TCR Ⅴβ subfamily and cytokines are changed in HBV-ACLF patients.