CD4＋CD25＋Treg细胞和Th17细胞及白细胞介6与HBV相关慢加急性肝衰竭预后关系的Meta分析  

Relationship between CD4＋CD25＋Treg cells, Th17 cells and IL-6 and the prognosis of hepatitis B virus-related acute-on-chronic liver failure： a meta-analysis

作　　者：吕红[1] 潘宗琴[1] 胡世芸[1] 陈宇[1] 庄勤建[1] 姚新生[3] 徐林[3] 肖政[2] 邱隆敏[1] 

机构地区：[1]遵义医学院附属医院感染科,563003 [2]遵义医学院循证医学中心循证医学教育部网上合作研究中心遵义医学院分中心 [3]遵义医学院循证医学中心免疫学教研室

出　　处：《中华肝脏病杂志》2014年第7期493-498,共6页Chinese Journal of Hepatology

基　　金：贵州省优秀科技教育人才省长专项基金[黔省专合字（2008）111号];贵州省社会发展公关项目黔科合SY[2010]3049号.

摘　　要：目的 探讨CD4＋CD25＋调节性T淋巴细胞（Tregs）、辅助性T17细胞（Th17）、白细胞介素6 （IL-6）在HBV相关慢加急性肝衰竭（ACLF）疾病进展及预后中的价值. 方法 检索CNKI、万方、维普、PubMed、Embase、SCI数据库中Treg细胞与ACLF相关研究文献,按照纳入及排除标准筛选文献,选择NOS标准评价文献质量,按照PICOS原则提取资料,采用RevMan 5.1软件进行Meta分析. 结果 共纳入9个病例对照研究,Meta分析显示：ACLF患者外周血CD4＋CD25＋Treg细胞频率高于慢性乙型肝炎（CHB）组患者[MD=0.59,95％可信区间（CI）为（1.68 ～ 2.85）]及健康对照组（HC） [MD=1.12,95％ CI为（1.42 ～ 3.66）],但差异无统计学意义（P值均＞0.05）;而ACLF患者外周血Th17细胞频率高于CHB患者[MD=1.73,95％ CI为（0.21 ～ 3.26）]及HC[MD=1.62,95％ CI为（0.52 ～ 2.72）],差异有统计学意义（P值均＜0.05）.ACLF患者外周血IL-6含量高于CHB患者[MD=11.69,95％ CI为（1.98 ～ 21.40）]及HC[MD=13.17,95％ CI为（1.38 ～ 24.95）],差异有统计学意义（P值均＜0.05）. 结论 CD4＋CD25＋Treg细胞可能为影响ACLF疾病进展及预后的重要保护因素;而Th17细胞及IL-6为影响ACLF疾病进展及预后的危险因素.Objective To investigate the role ofCD4＋CD25＋ T regulatory （Treg） cells,T helper （Th）17cells and interleukin （IL）-6 in the progression of hepatitis B virus （HBV）-related acute-on-chronic liver failure （ACLF） and determine their value as prognostic markers.Methods The Chinese National Knowledge Infrastructure （CNKI）,WanFang,Chinese Scientific Journals （VIP）,PubMed,Embase and Web of Science databases were searched for English language case-control studies on the relationship between regulatory T lymphocytes and ACLF.The quality of included studies was assessed using the Newcastle-Ottawa scale.The meta-analysis was designed according to the PICOS approach recommended by the Preferred Reporting Items for Systematic reviews and Meta-Analyses （PRISMA） statement.RevMan software,version 5.1,was used to perform the meta-analysis.Results Nine case-cohort studies were selected for inclusion in the metaanalysis.The results of the meta-analyses showed that the level of CD4＋CD25＋ Treg cells was not significantly different between patients with HBV-related ACLF and patients with chronic hepatitis B （CHB） （mean difference （MD） =0.59,95% confidence interval （CI）-1.68,2.85,P =0.61） nor between patients with HBVrelated ACLF and healthy controls （MD =1.12,95% CI：-1.42,3.66,P =0.39）.Thus,it appears that ACLF patients do not have a higher level of CD4＋CD25＋ Treg cells than CHB patients or healthy controls.However,the ACLF patients did appear to have a significantly higher level of Th17 cells than both the CHB patients （MD =1.73,95% CI：0.21,3.26,P =0.03） and the healthy controls （MD =1.62,95% CI：（0.52,2.72,P =0.004）.In addition,the ACLF patients also had significantly higher level than both the CHB patients （MD =11.69,95%CI：1.98,21.40,P =0.02） and the healthy controls （MD =13.17,95% CI：1.38,24.95,P =0.03）.Conclusion CD4＋CD25＋ Treg cells may be an important protective factor in the progression and prognosis of HBV-related ACLF,while Thl7 cell

关 键 词：肝功能衰竭 T淋巴细胞 调节性 辅助性T细胞17 META分析 

分 类 号：R575.3[医药卫生—消化系统]