HBV相关慢加急性肝衰竭患者Th17、Treg变化及其与临床相关性  

Frequency of Th17 and Treg in HBV-related acute-on-chronic liver failure and its clinical value

作　　者：阚延婷 甘建和[1] 孙蔚[1] 冯婷婷[1] 

机构地区：[1]苏州大学附属第一医院感染科,江苏215006

出　　处：《肝脏》2016年第2期89-91,共3页Chinese Hepatology

基　　金：国家"十二五"科技重大专项(2012ZX10002004-008)

摘　　要：目的研究Th17、Treg及Th17/Treg在乙型肝炎相关慢加急性肝衰竭(ACHBLF)患者外周血的变化,及其与病情进展及预后的相关性。方法选取33例ACHBLF患者,30例慢性乙型肝炎患者及11名健康对照。用流式细胞技术检测血清中Th17、Treg频数,分析ACHBLF患者Th17、Treg频数的变化及其与TBil、ALT、PT等指标的相关性。结果ACBLF患者的Th17(1.96±0.99)%比CHB患者(0.59±0.40)%及健康对照者(0.26±0.20)%高(P<0.05);ACHBLF的Th17/Treg(0.46±0.32)比CHB患者(0.12±0.11)及健康对照者(0.07±0.06)的高(P<0.05);ACHBLF患者中,死亡者的Th17比存活者高;Th17细胞频数及Th17/Treg与PT、ALT及AST呈正相关(P<0.05),与总胆红素无显著相关性,Th17/Treg与AFP呈正相关(P<0.05)。结论 ACHBLF患者存在不同程度的免疫功能紊乱,Th17及Th17/Treg与病情进展相关,且对患者预后有重要价值,Th17越高预后越差。Objective To investigate the frequency of peripheral Th17,Treg and Th17/Treg in patients with hepatitis B-related acute-on-chronic liver failure（HBV-ACLF）,and its correlation with disease progression and prognosis.Methods Seventy-four cases were enrolled,including 33 HBV-ACLF cases（HBV-ACLF group）,30 chronic hepatitis B cases（CHB group）and 11 healthy cases（control group）.The frequency of Th17 and Treg cells and surface antigen quantity in peripheral blood were detected in three groups with flow cytometry technique,respectively.Correlation analysis between changes of Th17 and Treg frequency in the HBV-related ACLF cases and total bilirubin（TBiL）,alanine aminotransferase（ALT）and prothrombin time（PT）was performed.Results Frequency of Th17,Treg cells and proportion of Th17/Treg were higher in HBV-ACLF patients than those in CHB and control group（P〈0.05）,respectively.In HBV-ACLF group,frequency of Th17 in dead patients were higher than that in survivors;frequency of Th17 and Th17/Treg were positively correlated with PT,ALT and AST（P〈0.05）with no significant correlation with TBiL.Additionally,Th17/Treg was also positively correlated with alpha fetoprotein（AFP）（P〈0.05）.Conclusion There were different degrees of immune dysfunction in HBV-ACLF patients.Frequency of Th17 and Th17/Treg were associated with disease progression.Higher frequency of Th17 predicted worse prognosis,which revealed it might be important indicators for those patients.

关 键 词：TH17 TH17/TREG ACHBLF 病情进展 预后 

分 类 号：R512.62[医药卫生—内科学]