CAJ | 학술논문

目的：探讨乙型肝炎病毒相关慢加亚急性肝功能衰竭(SACLF)患者外周血 Th17、Treg、Th17/Treg 比值变化及评估预后的意义。方法采用流式细胞仪分别检测42例 SACLF 患者(SACLF 组)、20例慢性乙型肝炎(CHB)患者(CHB 组)以及20例健康人(健康对照组)外周血 Th17、Treg、Th17/Treg 的比值。研究 SACLF 组 Th17/Treg 与终末期肝病评分(MELD)的相关性。结果 SACLF 组及 CHB 组 Th17频数分别为(2.51±0.57)%、(0.96±0.35)%,均较健康对照组(0.34±0.22)%明显升高(P <0.05)；SACLF 组与 CHB 组比较差异有统计学意义(P <0.05)。SACLF 组 Treg 频数较健康对照组升高(P <0.05)；CHB 组 Treg 频数与健康对照组比较差异无统计学意义(P >0.05)；SACLF 组与 CHB 组间比较差异有统计学意义(P <0.05)。SACLF 组及 CHB 组患者 Th17/Treg 比值分别为(0.43±0.16)、(0.23±0.18),均较健康对照组(0.07±0.15)明显升高(P <0.05),且 SACLF 组与 CHB 组间比较差异有统计学意义(P <0.05)。SACLF 患者 MELD 评分与 Th17、Th17/Treg 与呈正相关(r =0.647、0.566,P <0.05),与 Treg 无明显相关性(P >0.05)。结论 Th17/Treg 失衡可能是乙型肝炎重症化的机制之一,SACLF 组免疫失衡程度尤其是 Th17的升高均与预后呈正相关。
목적：탐토을형간염병독상관만가아급성간공능쇠갈(SACLF)환자외주혈 Th17、Treg、Th17/Treg 비치변화급평고예후적의의。방법채용류식세포의분별검측42례 SACLF 환자(SACLF 조)、20례만성을형간염(CHB)환자(CHB 조)이급20례건강인(건강대조조)외주혈 Th17、Treg、Th17/Treg 적비치。연구 SACLF 조 Th17/Treg 여종말기간병평분(MELD)적상관성。결과 SACLF 조급 CHB 조 Th17빈수분별위(2.51±0.57)%、(0.96±0.35)%,균교건강대조조(0.34±0.22)%명현승고(P <0.05)；SACLF 조여 CHB 조비교차이유통계학의의(P <0.05)。SACLF 조 Treg 빈수교건강대조조승고(P <0.05)；CHB 조 Treg 빈수여건강대조조비교차이무통계학의의(P >0.05)；SACLF 조여 CHB 조간비교차이유통계학의의(P <0.05)。SACLF 조급 CHB 조환자 Th17/Treg 비치분별위(0.43±0.16)、(0.23±0.18),균교건강대조조(0.07±0.15)명현승고(P <0.05),차 SACLF 조여 CHB 조간비교차이유통계학의의(P <0.05)。SACLF 환자 MELD 평분여 Th17、Th17/Treg 여정정상관(r =0.647、0.566,P <0.05),여 Treg 무명현상관성(P >0.05)。결론 Th17/Treg 실형가능시을형간염중증화적궤제지일,SACLF 조면역실형정도우기시 Th17적승고균여예후정정상관。
ABSTRACT:Objective To investigate the changes of T helper 1 7 (Th1 7),regulatory T cells (Treg)and Th1 7/Treg in peripheral blood of patients with HBV-related subacute-on-chronic liver failure(SACLF)and their prognostic significance.Methods Th1 7,Treg and Th1 7/Treg were detected in 42 patients with SACLF,20 patients with chronic hepatitis B (CHB)and 20 cases of normal control group by flow cytometry.The relationship between Th1 7/Treg and MELD were evaluated in patients with SACLF.Results Th1 7 of SACLF group (2.5 1 ±0.57 )%,was significantly higher than CHB patients and health control,(5.84±1.50)%,(4.82 ± 1.43)% (P <0.05 );Treg of SACLF group was also significantly higher than CHB group and healthy control (P <0.05);but there was no statistically significant difference in Th17 and Treg between CHB group and healthy control (P >0.05);The Th17/Treg in SACLF group and the CHB group 0.43±0.1 6 and 0.23 ±0.18,respectively,both increased significantly compared with healthy control,0.07 ± 0.1 5(P <0.05 ),and the difference between SACLF group and CHB group was also statistically significant (P <0.05).The MELD score of SACLF group,was positively correlated with Th1 7 and Th1 7/Treg (r =0.65,0.57,P <0.05),but no obvious correlation with Treg was found (P >0.05 ).Conclusion The imbalance of Th1 7/Treg may participate in the pathogenesis of severe hepatitis B,and its imbalance extents,especially the rise of Th1 7,which was positively correlated with prognosis.