外周血中Treg细胞和Th17细胞与慢性乙型肝炎相关性的Meta分析  

Correlation between peripheral blood Tregs and Th17 cells and disease progression and prognosis in chronic hepatitis B patients: A Meta-Analysis

作　　者：潘宗琴[1] 吕红[1] 胡世芸[1] 陈宇[1] 陈妍雯 肖政[2,3] 邱隆敏[1] 

机构地区：[1]遵义医学院附属医院感染科,贵州遵义563099 [2]遵义医学院循证医学中心 [3]循证医学教育部网上合作研究中心遵义医学院分中心,贵州遵义563099

出　　处：《遵义医学院学报》2014年第6期634-640,共7页Journal of Zunyi Medical University

基　　金：贵州省优秀科技教育人才省长专项基金资助项目(NO:黔省专合字(2008)111);贵州省社会发展攻关项目资助(NO:黔科合SY[2010]3049)

摘　　要：目的探讨Tregs和Th17细胞在不同HBV感染状态频率特征,以期揭示其对CHB转归影响,为临床干预提供依据。方法计算机检索Pubmed、SCI、Embase、CNKI、CBM及万方等数据库,依据Newcastle-Ottawa Scale(NOS)标准评价文献质量,按照PICOS原则提取资料,采用Rev Man 5.1软件进行Meta分析。结果纳入文献12篇。CHB外周血中Tregs及Th17细胞含量均高于健康对照者,但Tregs/Th17低于健康对照者,差异均具有统计学意义(P<0.00001、P<0.00001、P=0.04);CHB患者外周血中Tregs低于As C(P=0.57),而Th17细胞高于As C(P=0.25);CHB外周血中Tregs含量高于AHB(P=0.002),Th17细胞低于AHB(P=0.34);随着CHB病情加重外周血中Tregs含量降低(P=0.43),Th17细胞含量升高(P=0.02),Tregs/Th17比值增大(P=0.17)。结论 Tregs及Th17细胞在不同HBV感染状态表现不同的消长情况。Tregs/Th17失衡可能与CHB发生、发展及转归密切相关,Tregs及Th17细胞有望成为CHB预后及转归的重要预警标志。Objective To investigate the distribution characteristics of Tregs and Th17 cells in peripheral blood in the different patients with HBV infection and reveal the impacts of Tregs and Th17 cells on the prognosis of chronic hepatitis B（ CHB） and further provide the evidences for clinical intervention. Methods Two reviewers independently searched relevant articles in the databases（ Pub Med,SCI,Embase,CNKI,CBM and Wan Fang）and then evaluated the quality,extracted data and synthesized the data by meta analysis. Results Twelve case-control studies were included with low quality. Compared with the healthy controls,higher levels of Tregs and Th17 cells in CHB patients（ P〈0. 00001,P〈0. 00001） but lower ratio of Tregs to Th17 cells in CHB patients（ P = 0. 04） were indicated. The Tregs levels were lower in CHB patients than HBV carriers（ P = 0. 57） and the Th17 cells level was higher in CHB patients than HBV carriers（ P = 0. 25）. Compared with acute hepatitis B（ AHB） patients,the higher Tregs levels and lower Th17 cells levels in CHB patients were shown（ P = 0. 002,P = 0. 34）. With the aggravation of the CHB patient＇s condition,the Tregs levels in the peripheral blood were reduced（ P = 0. 43） and the Th17 cells levels were increased（ P = 0. 02） with the increased ratio of Tregs to Th17 cells（ P = 0. 17）. Conclusion In different HBV infection state,the levels of Tregs and Th17 cells tended to ebb and flow. The imbalance of Tregs / Th17 is closely associated with the occurrence,development and prognosis of CHB patients,suggesting Tregs and Th17 cells might be important warning signs of the progression and prognosis in CHB.

关 键 词：慢性乙型肝炎 调节性T细胞 辅助性T细胞17 META分析 

分 类 号：R512.6[医药卫生—内科学]