外周血Th22和Th17细胞对HBV相关性肝衰竭的预测价值  

Value of peripheral Th22 and Th17 to predicting the prognosis of chronic hepatitis B virus liver failure

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

机构地区：[1]南通市第三人民医院传染科,江苏南通226006

出　　处：《中华实用诊断与治疗杂志》2015年第1期59-61,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：目的探讨外周血Th22、Th17细胞对乙型肝炎病毒(hepatitis B virus,HBV)相关性肝衰竭的预测价值。方法采用流式细胞技术检测36例HBV相关性肝衰竭患者(肝衰竭组)、29例HBV相关慢性肝炎患者(慢性肝炎组)和16例体检健康者(对照组)外周血Th22、Th17水平,计算Th17/Th22,分析外周血Th22、Th17与HBV相关性肝衰竭患者肝功能、凝血酶原时间的相关性,以及对HBV相关性肝衰竭的预测价值。结果肝衰竭组外周血Th22、Th17、Th17/Th22分别为(8.275±3.147)%、(9.542±2.507)%、1.261±0.428,慢性肝炎组分别为(5.365±1.691)%、(6.261±1.843)%、1.255±0.487,对照组分别为(2.330±1.097)%、(3.392±1.637)%、1.613±0.696,肝衰竭组、慢性肝炎组以上指标与对照组比较差异均有统计学意义(P<0.05),肝衰竭组外周血Th22、Th17水平与慢性肝炎组比较差异有统计学意义(P<0.01);肝衰竭组外周血Th22与Th17呈正相关(r=0.706,P=0.000),Th22、Th17细胞与白蛋白(r=-0.540、P=0.000,r=-0.500、P=0.000)、总胆红素(r=0.420、P=0.001,r=0.437、P=0.000)、凝血酶原时间(r=0.495、P=0.000、r=0.492、P=0.000)相关;外周血Th22、Th17预测HBV相关性肝衰竭发生的特异性、阳性预测值分别为89.7%、87.0%及93.1%、92.6%。结论 Th22、Th17在一定程度上可反映HBV相关肝脏疾病的严重程度,可作为HBV相关性肝衰竭的预测指标。Objective To explore the value of peripheral Th22 and Th17 to predicting the prognosis of chronic hepatitis B virus（HBV）liver failure.Methods Peripheral Th22 and Th17 cells were detected by flow cytometry in 36 patients with chronic HBV liver failure（liver failure group）,29 patients with chronic HBV hepatitis（hepatitis group）and 16 healthy volunteers（control group）,to analyze the correlations of Th22 and Th17 cells with liver function and prothrombin time（PT）in liver failure group as well as the predicting value of Th22 and Th17 cells to HBV liver failure.Results Peripheral Th22,Th17 and Th17/Th22 were（8.275±3.147）%,（9.542±2.507）% and 1.261±0.428 in liver failure group,and（5.365±1.691）%,（6.261±1.843）% and 1.255±0.487 in hepatitis group,showing significant differences in comparison with control group（（2.330±1.097）%,（3.392±1.637）%,1.613±0.696）（P〈0.05）.There were significant differences in Th22 and Th17levels between liver failure group and hepatitis group（P〈0.01）.In liver failure group,Th22 was positively correlated with Th17（r=0.706,P=0.000）,and Th22 and Th17 were correlated with albumin（r=-0.540,P=0.000;r=-0.500,P=0.000）,total bilirubin（r=0.420,P=0.001;r=0.437,P=0.000）and prothrombin time（r=0.495,P=0.000;r=0.492,P=0.000）.The specificities of Th22 and Th17were 89.7% and 87.0%,and the positive predictive values of Th22 and Th17 were 93.1% and 92.6% for HBV liver failure.Conclusion Th22 and Th17 can reflect the severity of HBV liver disease,and can be used as a prognostic marker for HBV liver failure.

关 键 词：乙型肝炎病毒 肝衰竭 TH22细胞 TH17细胞 

分 类 号：R512.62[医药卫生—内科学] R575.3[医药卫生—临床医学]