胆管结石患者外周血胆红素水平与调节性T淋巴细胞变化的相关性  

Correlation of peripheral blood bilirubin level with Tregs in patients with bile duct stones

作　　者：刘航 李为民[2] 刘浩润[2] 王瑞官[2] 赵洪强[2] 王义真 

机构地区：[1]解放军医学院,100853 [2]解放军第309医院肝胆外科

出　　处：《中华肝胆外科杂志》2016年第4期253-257,共5页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的探讨胆总管结石所致黄疸患者外周血胆红素水平与调节性T细胞（RegulatoryTCell，Treg，CD4＋CD25＋Foxp3＋Tcells）变化的相关性。方法采用流式细胞技术和酶联免疫吸附法检测27例胆管结石所致黄疸患者治疗前后外周血Treg表达水平、血胆红素水平以及细胞因子白细胞介素-10（IL-10）、转化生长因子-β（TGF-β）的水平，分析治疗前后Treg细胞表达以及IL-10、TGF-β水平与胆红素水平变化的相关性。结果治疗前患者外周血总胆红素和直接胆红素水平分别为（102．8±33．1）mmol/L和（38．1±12．8）mmol／L。减黄治疗后患者外周血胆红素水平明显下降，分别为（15．3±5．7）mmol／L和（5．0±1．6）mmol／L，差异有统计学意义（P〈0．05）。减黄治疗后患者外周血Treg细胞表达水平由（4．2±2．0）％降至（2．4±1．0）％，差异明显（P〈0．05）。治疗前患者细胞因子IL-10、TGF-β水平分别为（171．4±13．7）pg／ml和（2016．0±657．0）pg／ml，治疗后IL-10、TGF-β分别下降至（92．1±7．4）pg／ml和（1686．04-168．0）pg／ml，差异有统计学意义（P〈0．05）。结论胆管结石所致梗阻性黄疸患者外周血胆红素及调节性T细胞水平明显高于正常。减黄治疗后患者外周血胆红素水平可明显下降至正常，调节性T细胞水平也降至正常，二者之间呈正相关。Objective To study and correlate serum bilirubin and regulatory T cell （Treg） levels in patients with bile duct stone. Methods Flow-cytometry and Enzyme-linked immunosorbent assay （Elisa） were used to study the peripheral blood expression level of Tregs and the bilirubin level in 27 patients with bile duct stones and jaundice. The changes in the expression level of Tregs and the hilirubin level were stu- died and correlated before and after treatment. Results After treatment, both the peripheral blood bilirubin level, the Tregs expression level and the cell cytokines decreased significantly. The total bilirubin level de- creased from （ 102. 8 ± 33.1 ） mmol/L to （ 15.3 ± 5.7 ） mmol/L （ P 〈 0. 05 ）, the direct bilirubin level de- creased from （38.1 ± 12. 8） mmol/L to （5.0 ±1.6） mmol/L （P 〈0. 05） ; the percentages of CD4＋ CD25 ＋ Foxp3 ＋ TcellsinCD4 ＋ T decreased from （4.2±2.0）% to （2.4±1.0）% （P〈0.05）. Before treat- ment, the levels of IL-10 and TGF-β were 171.4 ± 13.7 and 2 016 ± 657 pg/ml but after treatment, the two cytokines decreased to 92. 1 ± 7.4 and 1 686 ±168 pg/ml, respectively （ P 〈 0. 05 ）. Conclusions Patients with bile duct stones and jaundice presented with high expressions of bilirubin and Tregs level. These expres- sions returned to normal after effective treatment. The Tregs expression level was positively correlated with the bilirubin level.

关 键 词：胆管结石 黄疸 胆红素 调节性T细胞 

分 类 号：R575.7[医药卫生—消化系统]