乙型肝炎病毒相关慢加急性肝衰竭患者外周血T淋巴细胞受体β链Ⅴ区亚家族的表达及其意义  

The expression of T-cell receptor Ⅴβ subfamily in hepatitis B virus-related acute-on-chronic liver failure patients and its clinical significance

作　　者：施文娟[1] 李晓玲[2] 杨正茂[1] 王兆勋[1] 魏丽[1] 万红[1] 杨守良[1] 

机构地区：[1]兰州市第二人民医院传染科,730046 [2]西北民族大学附属医院内科

出　　处：《中华传染病杂志》2013年第11期667-671,共5页Chinese Journal of Infectious Diseases

基　　金：兰州市自然科学基金资助项目（2011-2-13）

摘　　要：目的 探讨乙型肝炎病毒相关慢加急性肝衰竭（HBV-ACLF）患者外周血T淋巴细胞受体β链Ⅴ区（TCR Ⅴβ）亚家族的表达及其临床意义.方法 选择兰州市第二人民医院2010年10月至2012年3月收治的HBV-ACLF患者28例（HBV-ACLF组）,同时选取同期住院的慢性乙型肝炎急性发作（CHB-F）患者32例（CHB-F组）和20名健康体检者（健康对照组）.采用RT-PCR检测TCR Ⅴβ亚家族水平,ELISA法检测血清中IL-2、IL-4、IL-6、IL-10、IFN-γ和TNF-α水平,对3组数据进行对比分析.3组间比较采用单因素方差分析,两组间均数比较用LSD-t检验,如不符合,则采用秩和检验.结果 3组间性别构成比和年龄比较差异均无统计学意义（均P＞0.05）;HBV-ACLF组与CHB-F组TBil、Alb、PTA、国际标准化比值（INR）、总胆固醇（TC）差异均有统计学意义（均P＜0.05）.HBV-ACLF组患者IL-2、IL-4、IL-10水平低于健康对照组（H值分别为14.061、31.681和31.380,均P=0.000）,而IL-6、IFN-γ水平均高于健康对照组（H值分别为13.332和12.380,均P=0.000）.CHB-F组IL-4、IL-10、TNF-α水平低于健康对照组（H值分别为21.152、18.401和10.002,均P=0.000）;HBV-ACLF组IL-2、IL-10、TNF-α水平低于CHB-F组（H值分别为8.795、9.414和8.423,P值分别为0.003、0.002和0.004）,而IL-6、IFN-γ水平高于CHB-F组（H值分别为5.889和7.534,P值分别为0.015和0.006）.秩和检验分析显示,3组间△Ct1、△Ct5、△Ct7、△Ct12、△Ct15、△Ct20、△Ct22、△Ct23值差异均有统计学意义（H值分别为20.368、14.368、19.500、31.532、19.985、19.116、41.752和20.649,均P＜0.05）.结论 HBV-ACLF患者体内TCR Ⅴβ部分亚家族以及细胞因子的表达水平发生了改变.Objective To investigate the expression and clinical significance of T-cell receptor （TCR） Ⅴβ subfamily in hepatitis B virus （HBV）-related acute-on-chronic liver failure （HBV-ACLF） patients.Methods Twenty-eight patients with HBV-ACLF （HBV-ACLF group） and 32 patients with chronic hepatitis B flare （CHB-F group）,who were treated in The Second People＇s Hospital from Oct.2010 to Mar.2012,and 20 healthy controls （HC group） were included in the study.Reverse transcriptase-polymerase chain reaction was used to detect the levels of TCR Ⅴβ subfamily and enzymelinked immunosorbent assay was used to detect the levels of serum cytokines [interleukin （IL）-2,IL-4,IL-6,IL-10,interferon （IFN）-γ and tumor necrosis factor （TNF）-α）] in the three groups.The comparison among three groups was done by one-way analysis of variance and the comparison between two groups was done by LSD-t test or rank sum test.Results The three groups had similar gender and age distribution （all P〉0.05）.The HBV-ACLF group had significant different profiles of total bilirubin,albumin,prothrombin activity,international normalized ratio and cholesterol tatol compared with the CHB-F group （all P〈0.05）.For patients in the HBV-ACLF group,the serum IL-2,IL-4,and IL-10 levels were lower（all P=0.000）,and the IL-6 and IFN γ levels were higher than those of the HC group （all P=0.000）.The IL-4,IL-10,and TNF-α levels in the CHB-F group were also significantly lower than those of the HC group （all P=0.000）.Compared with the CHB-F group,the HBV-ACLF group had significantly lower IL-2,IL-10,and TNF-α levels （P=0.003,0.002,0.004）,and higher IL-6 and IFN-γ levels （P=0.015,0.006）.By one-way analysis of variance,there were significantly differences of △Ct1,△Ct5,△Ct7,△Ct12,△Ct15,△Ct20,△Ct22,and △Ct23 among the three groups （H=20.368,14.368,19.500,31.532,19.985,19.116,41.752 and 20.649,all P〈0.05）.Conclusion The expression levels of TCR Ⅴβ subfamily and cytokines are cha

关 键 词：肝炎 乙型 慢性 肝炎病毒 乙型 肝功能衰竭 受体 抗原 T细胞 细胞因子类 

分 类 号：R575.5[医药卫生—消化系统]