乙肝相关慢加急性肝衰竭患者Th17细胞水平及其临床意义  

Th17 cells in patients with HBV-related acute-on-chronic liver failure

作　　者：张耿林[1] 谢冬英[1] 林炳亮[1] 彭亮[1] 谢婵[1] 张绍全[1] 张宇锋[1] 赖箐[1] 朱建芸[1] 张英[1] 黄仰甦[1] 胡朝霞[1] 高志良[1] 

机构地区：[1]中山大学附属第三医院感染病科,广东广州510630

出　　处：《热带医学杂志》2011年第5期573-576,579,共5页Journal of Tropical Medicine

基　　金："十一五"国家科技重大专项(2008ZX102002-007);国家"973"项目(2007CB513006);国家自然科学基金(30971356)

摘　　要：目的探讨乙肝相关慢加急性肝衰竭(HBV-ACLF)外周血Th17细胞的表达及其与临床转归的关系。方法采用流式细胞术分析外周血中Th17细胞比例,flowcytomix技术检测血清中IL-17的水平,荧光PCR检测HBV-DNA载量,ELISA检测HBeAg的状态,分析Th17细胞及IL-17的表达与HBV病毒及预后的关系。结果与健康对照组及慢乙肝组相比,HBV-ACLF患者Th17细胞及IL-17水平明显升高(P<0.01),且Th17细胞与IL-17水平成正相关;进一步分析发现不同病毒复制水平及HBeAg状态的HBV-ACLF患者Th17细胞及IL-17的差异无统计学意义;与预后好转患者相比,预后不佳HBV-ACLF患者Th17细胞及IL-17水平明显增高(P<0.05),且IL-17的水平与终末期肝病评分成正相关。结论 Th17细胞可能参与了HBV-ACLF的发病机制,且IL-17的表达越高可能提示患者的预后不佳。Objective To investigate Th17 cells and its relationship with prognosis of patients with HBV-related acute-on-chronic liver failure.Methods Peripheral blood samples were collected from 37 HBV-ACLF patients,26 chronic hepatitis B patients and 17 normal controls.Th17 cells in circulating blood were determined by flowcytometry.IL-17 level was measured by flowcytomix.HBeAg and HBV-DNA loads were measured by ELISA and fluorescent PCR,respectively.The frequency of Th17 cells and the level of IL-17 in HBV-ACLF patients and their correlations with HBeAg,HBV-DNA loads and prognosis were analyzed.Results Higher frequency of Th17 cells and level of IL-17 were detected in patients with HBV-ACLF than those of the NC subjects and CHB patients（P0.01）.There was positive correlation between Th17 cells and the level of IL-17,but no significant differences in the level of IL-17 and frequency of Th17 cells were observed in HBV-ACLF patients with different HBV-DNA levels and different states of HBeAg.However,Th17 cells and IL-17 were markedly higher in patients with poor outcome than those with good outcome.Furthermore the level of IL-17 was positively correlated with MELD score of HBV-ACLF patients.Conclusion Th17 cells may contributed to the mechanism of the HBV-ACLF and the elevated level of IL-17 may be a good marker to indicate unfavorable poor prognosis in HBV-ACLF patients.

关 键 词：慢加急性肝衰竭 乙型肝炎病毒 IL-17 预后 TH17细胞 

分 类 号：R512.62[医药卫生—内科学]