乙型肝炎病毒相关慢加亚急性肝衰竭患者Th17及Th1表达意义  

Expressions of peripheral Th17 and Th1 in patients with hepatitis B virus-related sub-acute and chronic liver failure

作　　者：邹美银[1] 章幼奕[1] 周慧娟[1] 汪美华[1] 秦刚[1] 

机构地区：[1]南通市第三人民医院感染病科,江苏南通226006

出　　处：《中华实用诊断与治疗杂志》2013年第10期948-950,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：江苏省南通市社会发展计划项目(S2010046)

摘　　要：目的探讨Th17及Th1在乙型肝炎病毒(hepatitis B virus,HBV)相关慢加亚急性肝衰竭(sub-acute and chronic liver failure,SACLF)患者表达水平及对疾病判断的临床意义。方法 HBV相关SACLF患者36例(SACLF组),慢性乙型病毒性肝炎患者29例(CHB组),同期体检健康者16例(对照组),采用流式细胞术检测3组外周血Th17与Th1水平,分析其与肝功能、凝血酶原时间、HBV标志物的相关性;分析Th17、Th1对SACLF发生的预测价值。结果 SACLF组与CHB组Th17、Th1与白蛋白、胆碱酯酶呈负相关,与总胆红素、凝血酶原时间呈正相关(P<0.05);Th17、Th1、Th1/Th17与HBsAg、HBeAg、HBV DNA均无相关性(P>0.05),HBV不同复制状态下Th17、Th1与Th1/Th17水平差异无统计学意义(P>0.05);SACLF组Th17、Th1水平高于CHB组与对照组,CHB组高于对照组(P<0.05),3组间Th1/Th17差异无统计学意义(P>0.05);Th17、Th1均能预测SACLF发生,二者联合预测SACLF发生准确性为86.2%,模型方程拟合优度高。结论 Th17、Th1与肝脏损伤程度相关,可作为预测SACLF发生及疾病严重程度的判断指标。Objective To explore the expressions of Th17 and Th1 in the patients with hepatitis B virus （HBV）-related sub acute and chronic liver failure （SACLF）, and the significance in judging the disease. Methods The levels of Th17 and Th1 were detected in peripheral blood in 36 patients with HBV-related SACLF, 29 patients with chronic hepatitis B （CHB） and 16 healthy controls by using flow cytometry. The correlations of Th17 and Th1 with liver function, prothrombin time （PT） and HBV markers were analyzed. The predicting value of Th17 and Th1 to SACLF was analyzed. Results The levels of Th17 and Th1 were negatively correlated with albumin and cholinesterase, and positively correlated with total bilirubin and prothrombin time in SACLF group （P〈0.05）. The levels of Th17, Th1 and Th1/Th17 were not correlated with HBV surface antigen, HBV e antigen and HBV DNA （P〉0.05）, and showed no significant difference in different HBV replication status （P〉0.05）. The levels of Th17 and Th1 were higher in SACLF group than those in CHB group, and were higher in CHB group than those in control group （P〈0.05）. There was no significant difference in Th1/Th17 among three groups （P〉0.05）. Both Th17 and Th1 could predict SACLF, and the accurate predicting rate of combined detection of them was 86.2 %. Conclusion Th17 and Th1 are closely correlated with the injury degree of liver. The levels of Th17 and Th1 could be used as markers for predicting the occurrence of SACLF and the severe degree of the disease.

关 键 词：乙型肝炎病毒 肝衰竭 TH17 TH1 

分 类 号：R575.3[医药卫生—消化系统]