慢加急性肝衰竭患者人工肝治疗后外周血T淋巴细胞亚型变化研究  

Changes of peripheral T-lymphocyte subsets in acute-on-chronic liver failure patients with artificial liver support system

作　　者：朱丽 王丽 曾义岚 吴蓓 段萌 

机构地区：[1]四川省成都市公共卫生临床医疗中心,610011

出　　处：《检验医学与临床》2015年第4期476-478,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨慢加急性肝功能衰竭(ACLF)患者应用人工肝治疗后外周血T淋巴细胞亚型变化情况。方法连续性收治38例ACLF患者,其中18例接受人工肝支持治疗(ALSS)治疗的患者为治疗组,20例接受常规药物治疗的患者为对照组。分别于治疗前,治疗后1、2、3、4周检测两组患者肝、肾功能,凝血功能以及外周血T淋巴细胞亚型水平。结果治疗组患者28d生存率为66.6%(12/18),明显高于对照组的40.0%(8/20),差异有统计学意义(P<0.05)。两组患者治疗前外周血T淋巴细胞CD4+/CD8+比值比较,差异无统计学意义(P>0.05)。在对照组28d存活的8例患者中,可见CD4+T淋巴细胞水平明显上升,而CD8+T淋巴细胞水平下降,CD4+/CD8+比值上升(P<0.05)。而在治疗组存活的12例患者中,这种变化更为明显(P<0.05)。两组患者天门冬氨酸氨基转移酶、肌酐、尿素以及国际化标准比值水平均较治疗前明显好转,差异有统计学意义(P<0.05)。结论外周血T淋巴细胞亚型水平可以了解ACLF患者免疫功能情况,有助于评价临床疗效和预后情况。Objective To analysis the changes of peripheral T-lymphocyte subsets in acute-on-chronic liver failure patients（ACLF）with artificial liver support system（ALSS）.Methods Thirty-eight ACLF patients were divided into treatment group（n=18）and control group（n=20）.Patients in the treatment group were received ALSS treatment while patients in the control group were only received normal medical therapy.Hepatorenal function,coagulation function and peripheral T-lymphocye subsets were measured in five time points（before treatment,1 week,2 weeks,3 weeks and 4 weeks after treatment）.Results No significant difference could be found in sex,age,hepatorenal function between these two groups（P〉0.05）.These 28 days death rate in treatment group and control group were 40.0% and 66.6% respectively.The levels of CD8＋decreased in the survivals of control group,while the levels of CD4＋and ratio of CD^4＋/CD^8＋increased（P〈0.05）.These changes were more significantly in the survivals of treatment group（P〈0.05）.The levels of aspartate aminotransferase（AST）,creatinive（SCr）,urea（BUN）and international mormalized ratio（INR）of survivals were also declined in the end of 28 days（P〈0.05）.Conclusion Peripheral T-lymphocyte subsets minght play an important role in the pathophysiology of ACLF and present reliable biomarkers for evaluation of curative effect and prognosis.

关 键 词：慢加急性肝衰竭 人工肝 外周血T淋巴细胞亚型 

分 类 号：R734.2[医药卫生—肿瘤]