肝内IFN—γ及其分泌细胞在乙型慢加急性肝衰竭发病机制中的作用  

Roles of intrahepatic expression of interferon gamma and expression of its secreting cells in the pathogenesis of HBV-related acute-on-chronic liver failure

作　　者：孙颖[1] 李保森[1] 徐东平[1] 张政[1] 赵景明[1] 周光德[1] 孙艳玲[1] 黄磊[2] 福军亮[1] 杨永平[1] 金磊[1] 张伟[1] 赵军[1] 辛绍杰[1] 王福生[1] 邹正升[1] 

机构地区：[1]解放军第三○二医院,北京100039 [2]北京大学人民医院,北京100009

出　　处：《传染病信息》2008年第4期227-230,共4页Infectious Disease Information

基　　金：国家自然科学基金(30571749)

摘　　要：目的通过研究肝内促炎细胞因子 IFN-γ的表达及 IFN-γ的分泌细——T淋巴细胞的数量,以明确二者在乙型慢加急性肝衰竭(acute-on-chronic liver failure,ACLF)发病机制中的作用。方法采用免疫组化方法,分析乙型 ACLF 患者、慢性乙型肝炎(乙肝)患者及正常对照组肝内 IFN-γ的原位表达以及其分泌细胞 CD4^+T 淋巴细胞与 CD8^+T 淋巴细胞的数量。结果①乙型 ACLF 患者 IFN-γ阳性分泌细胞数均明显高于慢性乙肝患者及正常对照组,差异有统计学意义(P 均<0.001),慢性乙肝患者 IFN-γ阳性分泌细胞数明显高于正常对照组,差异有统计学意义(P<0.001);②乙型 ACLF 患者肝内CD4^+和 CD8^+T 淋巴细胞数量较慢性乙肝及正常对照组明显增加(P 均<0.001),慢性乙肝患者肝内 CD4^+和 CD8^+T 淋巴细胞数量较正常对照组明显增加(P 均<0.001);③肝内 IFN-γ阳性分泌细胞数量与 CD4^+T 淋巴细胞和 CD8^+T 淋巴细胞数量均具有明显的相关性(r=0.896和0.885,P 均<0.001)。结论乙型 ACLF 患者肝内 CD4^+T 淋巴细胞、CD8^+T 淋巴细胞数量的增加,其分泌的 IFN-γ的增加可能参与了 ACLF 的发病过程。Objective To determine the roles of the expression of intrahepatic proinflammatory interferon γ （IFN-γ ） and the number of T cells, which secreted IFN-γ , in the pathogenesis of HBV-related acute-on-chronic liver failure （ACLF）. Methods Immunohistochemistry was used to analyze in situ expressions of IFN- γ and the expression of CD4^＋ and CD8^＋ T lymphocytes in the livers of patients with ACLF, of patients with chronic hepatitis B （CHB） and of normal controls （NC）. Results （1） The number of IFN- γ -positive lymphocytes found in ACLF patients was significantly higher than that found in CHB patients and NC（both P〈 0.001 ）. The number of IFN-γ -positive lymphocytes found in CHB patients was significantly higher than that found in NC （P〈0.001）. （2） HBV-related ACLF patients exhibited a significant increase in the number of CD4^＋and CD8^＋ T lymphocytes compared with CHB and NC groups （all P〈0.001）. The number of CD4^＋ and CD8^＋ T lymphocytes found in CHB patients was also significantly higher than that found in NC （both P〈 0.001）. （3）The number of intrahepatic IFN- γ -positive cells was significantly correlated to the number of CD4^＋ and CD8^＋ T lymphocytes （r = 0.896 and 0.885, respectively, both P〈0.001）. Conclusions The increase in the expression of proinflammatory IFN-γ and the number of CD4^＋ and CD8^＋ T lymphocytes in the livers of patients with HBV-related ACLF may contribute to the pathogenesis of ACLF.

关 键 词：IFN-γ CD4^+T淋巴细胞 CD8^+T淋巴细胞 慢加急性肝衰竭 免疫组化 

分 类 号：R512.62[医药卫生—内科学]