肝内CD68阳性细胞及TNF-α在慢加急性乙型肝炎肝衰竭发病机制中的作用  

Intrahepatic expression of TNF-α and CD68+ cells in patients with acute-on-chronic hepatitis B liver failure

作　　者：赵军[1] 孙颖[1] 李保森[1] 徐东平[1] 张政[3] 赵景明[2] 周光德[2] 孙艳玲[2] 黄磊[4] 张伟[1] 辛绍杰[1] 王福生[3] 邹正升[1] 

机构地区：[1]解放军第三○二医院急症肝病科,北京市100039 [2]解放军第三0二医院病理科,北京市100039 [3]解放军第三0二医院生物治疗中心,北京市100039 [4]北京大学人民医院肝胆外科

出　　处：《实用肝脏病杂志》2009年第1期31-34,共4页Journal of Practical Hepatology

基　　金：国家自然科学基金(No.30571749)

摘　　要：目的通过研究肝内CD68+和TNF-α阳性细胞的表达,来探讨它们在乙型肝炎慢加急性肝衰竭(ACLF)发病机制中的作用。方法采用免疫组化法检测乙型肝炎ACLF患者、慢性乙型肝炎(CHB)患者及正常对照人群肝内TNF-α的表达以及其分泌细胞CD68+细胞的数量。结果ACLF患者肝内TNF-α阳性分泌细胞平均数为90/高倍视野(hpf),明显高于CHB患者及正常对照组(分别为12/hpf和5/hpf),差异均非常显著(P<0.001);ACLF患者肝内CD68+细胞平均数为94/hpf,明显高于CHB患者及正常对照组(分别为48/hpf和15/hpf),差异均非常显著(P<0.001);TNF-α阳性分泌细胞与CD68阳性细胞数量具有显著的正相关(r=0.866,P<0.001)。结论乙型肝炎ACLF患者肝内CD68+细胞数量明显增加,其分泌的TNF-α也明显增加,推测TNF-α可能参与了乙型肝炎ACLF的发病过程。Objective To determine the expression of intrahepatic proinflammatory TNF-α as well as its secreting cells（CD68＋ cells）to evaluate their roles in the pathogenesis of acute-on-chronic liver failure（ACLF）. Methods The expressions of TNF-α,and CD68＋ cells were analyzed in the livers of patients with ACLF,chronic hepatitis B（CHB）,and normal controls （NC）by using immunohistochemistry. Results The numbers of TNF-α positive cells found in ACLF patients were significantly higher than those in patients with CHB or NC（both P〈0.001）;ACLF patients exhibited significantly increased numbers of CD68 positive cells as compared to CHB or NC groups （P〈0.001）;The numbers of intrahepatic TNF-α positive cells were positively correlated with the numbers of CD68-positive cells （r=0.866,P〈0.001）. Conclusions The significant expression of proinflammatory TNF-α and increased accumulation of CD68 positive cells may contribute to the pathogenesis of ACLF in HBV-infected patients.

关 键 词：慢加急性肝衰竭 乙型肝炎 肿瘤坏死因子-Α CD68+细胞 

分 类 号：R512.62[医药卫生—内科学] 5R75.3[医药卫生—临床医学]