CAJ | 학술논문

目的：探讨HBV相关慢加亚急性肝衰竭（HBV-SACLF）患者外周血Th1、Th2、Th17的表达水平及意义。方法运用流式细胞技术检测38例HBV-SACLF患者、20例慢性乙型病毒性肝炎（CHB）患者、20名健康体检者（对照组）外周血中Th1、Th2、Th17的水平；动态观察HBV-SACLF患者早、中、晚期Th1、Th2、Th17的变化趋势。结果1.Th1在HBV-SACLF组与CHB组及对照组比较，明显升高（P1=0.04，P2=0.032）。Th2在HBV-SACLF组与CHB组及对照组比较，明显下降（P1=0.007，P2=0.041）。Th17在HBV-SACLF组与CHB组及对照组比较，明显升高（P1=0.003，P2＜0.001）。2.HBV-SACLF患者早期与中期，中期与晚期相比各细胞水平变化趋势：Th1逐渐降低（P1=0.001，P2=0.004）。Th2逐渐升高（P1=0.003，P2=0.048）。Th17逐渐升高（P1=0.002，P2=0.007）。结论 Th1、Th2、Th17的紊乱是导致HBV-SACLF发生、发展的关键因素，通过检测其在HBV-SACLF患者早、中、晚期的动态变化可以辅助判断机体的免疫状态，为临床的免疫调控治疗提供理论依据。
목적：탐토HBV상관만가아급성간쇠갈（HBV-SACLF）환자외주혈Th1、Th2、Th17적표체수평급의의。방법운용류식세포기술검측38례HBV-SACLF환자、20례만성을형병독성간염（CHB）환자、20명건강체검자（대조조）외주혈중Th1、Th2、Th17적수평；동태관찰HBV-SACLF환자조、중、만기Th1、Th2、Th17적변화추세。결과1.Th1재HBV-SACLF조여CHB조급대조조비교，명현승고（P1=0.04，P2=0.032）。Th2재HBV-SACLF조여CHB조급대조조비교，명현하강（P1=0.007，P2=0.041）。Th17재HBV-SACLF조여CHB조급대조조비교，명현승고（P1=0.003，P2＜0.001）。2.HBV-SACLF환자조기여중기，중기여만기상비각세포수평변화추세：Th1축점강저（P1=0.001，P2=0.004）。Th2축점승고（P1=0.003，P2=0.048）。Th17축점승고（P1=0.002，P2=0.007）。결론 Th1、Th2、Th17적문란시도치HBV-SACLF발생、발전적관건인소，통과검측기재HBV-SACLF환자조、중、만기적동태변화가이보조판단궤체적면역상태，위림상적면역조공치료제공이론의거。
Objective To investigate the dynamic change and clinical significance of Th1, Th2 and Th17 in peripheral blood of the patients with SACLF during different periods.Methods We detected the ratio of Th1, Th2 and Th17 from peripheral blood cells in 38 HBV-SACLF patients, 20 CHB patients and 20 health adults byfl uorescence-activated cell sorter; compared the above indicators among the three groups; observed dynamic changes of Th1, Th2 and Th17 during the nonage, metaphase and advanced stage of HBV-SACLF.Results 1.The ratios of Th1 in HBV-SACLF group were significantly higher than CHB group and control group (P1=0.04, P2=0.032). The ratios of Th2 in HBV-SACLF group were signifi cantly lower than CHB group and control group (P1=0.007,P2=0.041). The ratios of Th17 in HBV-SACLF group were significantly higher than CHB group and control group (P1=0.003,P2<0.001). 2.The ratios of Th1, Th2 and Th17 cells in the nonage, metaphase and advanced stage of 38 HBV-SACLF patients were as follows: The ratios of Th1 decreased gradually. There were also significant differences among the three periods (P1=0.001,P2=0.004). The ratios of Th2 increased gradually. There were also signifi cant differences among the three periods (P1=0.003,P2=0.048). The ratios of Th17 increased gradually. There were also signifi cant differences among the three periods (P1=0.002,P2=0.007). Conclusion The disorders of Th1, Th2 and Th17 were key factors in the development of HBV-SACLF. By detecting their dynamic changes in HBV-SACLF, we can judge patients' immune status and offer theoretical basis for the clinical treatment of immune regulation.