“慢加急”乙型肝炎肝功能衰竭患者外周血树突状细胞亚群的特点及其临床意义  

The characteristics of peripheral blood dendritic cells in HBV-infected patients with acute-on-chronic liver failure

作　　者：张文瑾[1] 范振平[1] 蔡少平[1] 吉英杰[1] 张政[1] 邹正升[1] 王福生[1] 

机构地区：[1]解放军第三○二医院,北京100039

出　　处：《肝脏》2010年第6期409-413,共5页Chinese Hepatology

基　　金：国家自然科学基金项目(30571749)

摘　　要：目的慢性乙型肝炎患者体内树突状细胞(DC)功能缺陷是导致宿主特异性免疫反应低下和病毒感染慢性化的主要因素。然而,目前还不清楚"慢加急"乙型肝炎肝功能衰竭患者体内的DC特点及其临床意义。方法在知情同意的基础上,本研究入组40例"慢加急"乙型肝炎肝功能衰竭患者,同时入组20例健康人和20例慢性乙型肝炎患者作为对照,调查上述人群外周血DC亚群的频率、功能及其临床意义。结果相对于健康人和慢性肝炎患者,"慢加急"乙型肝炎肝功能衰竭患者外周血浆样树突细胞(pDCs)频率明显降低,并且pDCs产生α干扰素(IFNα-)的能力也显著下降。进一步分析表明,pDC分泌IFNα-的能力在"慢加急"乙型肝炎肝功能衰竭死亡患者明显低于存活患者,并与肝功能衰竭严重程度呈显著负相关。结论 "慢加急"乙型肝炎肝功能衰竭患者外周血DC数量和功能明显降低,可作为疾病严重性的预测指标。Objective The functional deficiency of dendritic cell（DC） subsets has been demonstrated to mediate immune impairment and virus persistence in chronic hepatitis B virus（HBV）-infected patients,however,little information of these DCs was available in patients with acute-on-chronic liver failure（ACLF）.Methods Forty ACLF patients and 20 CHB patients as well as 20 healthy control（HC）subjects were enrolled into the study.The frequencies,functions and the clinical significance of these DC subsets were analyzed in these patients.Results As compared with CHB and HC subjects,the frequency of peripheral plasmacytoid dendritic cells（pDCs） was significantly decreased in ACLF patients.In addition,the capacity to produce interferon（IFN）-αof peripheral plasmacytoid pDCs was also significantly reduced in these ACLF patients as compared with CHB and HC subjects.Further analysis indicated that the capacity of pDCs to produce IFN-α was significantly higher in survivors than that in non-survivors.More importantly,the capacity of pDCs to produce IFN-α was found to be negatively correlated with the disease severity in these ACLF patients.Conclusion The frequency and function of peripheral pDCs were significantly impaired in ACLF patients;pDCs,therefore,may sever as a surrogate marker of disease progression in ACLF patients.

关 键 词：“慢性乙型肝炎 肝功能衰竭 树突状细胞 干扰素-Α 

分 类 号：R512.62[医药卫生—内科学]