Th17调节性T淋巴细胞失衡在药物性肝炎预后中的价值  

Predictive Value of Th17/Treg Dysregulation in Drug-Induced Hepatitis

作　　者：王艳[1] 黄小平[1] 顾静[1] 崔娟娟[1] 甘建和[1] WANG Yan HUANG Xiao-ping GU Jing CUI Juan-juan GAN Jian-he(Department of Infection, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, China)

机构地区：[1]苏州大学附属第一医院感染科,江苏苏州215006

出　　处：《中国血液流变学杂志》2016年第2期179-182,共4页Chinese Journal of Hemorheology

摘　　要：目的探讨Th17、Treg及Th17／Treg在药物性肝炎（drug-induced hepatitis，DIH）外周血中的变化，及其与病情进展和预后的关系。方法运用流式细胞技术检测57例药物性肝炎，20名健康体检者（对照组）外周血中Th17、Treg频数，分析其频数的变化及与丙氨酸转氨酶（ALT）、天门冬氨酸转氨酶（AST）、总胆红素（Tbi1）、凝血酶原时间（PT）的相关性。结果1．Th17在重度药物性肝炎（SDIH）、重型药物性肝炎（GDIH）组明显升高，对照组与任意一组，及重型药物性肝炎组分别与轻中度药物性肝炎（MMDIH）、重度药物性肝炎组比较，差异均有统计学意义（t=-3．412，-4．432，-4．578，-3．908，-2．823；P〈0．05）；Treg在轻中度药物性肝炎、重度药物性肝炎、重型药物性肝炎组明显升高，且对照组与任意一组比较，差异均有统计学意义（t=-．3．502，．5．055，．5．028；P〈0．05）；Thl7／Treg在重度药物性肝炎、重型药物性肝炎组明显升高，对照组分别与重度药物性肝炎、重型药物性肝炎组比较，及重型药肝组与轻中度药肝组比较，差异均有统计学意义（t=-2．574，-4．513，-4．225；P〈0．05）。2．Th17、Th17／Treg均与Tbi1、PT有明显相关性（P〈0．05），且均成正相关。3．药物性肝炎加重组与好转组比较，加重组其Th17、Th17／Treg值均明显升高，且差异均有统计学意义（t=-8．068，-2．309；P〈0．05）。结论重度及重型药物性肝炎患者可存在不同程度的免疫紊乱，Th17、Th17/Treg变化与病情进展相关，且对患者的预后有重要的临床价值。Objective To investigate the changes of Th17, Treg and Th17/Treg in peripheral blood in the drug-induced hepatitis with disease progression and prognosis. Methods We detected the ratio of Th17, Treg and Th17/Treg from peripheral blood cell in 57 drug-induced hepatitis patients and 20 health adults as the control group by fluorescence-activated cell sorter, and analyzed the changes of Th17 and Treg frequency and Th 17/Treg, and the correlation with ALT, AST, Tbil, and PT. Results 1.The ratio of Th17 in severe DIH （SDIH） and gravis drug-induced hepatitis （GDIH） was significantly increased, and the differences were all significant between the control group and any other groups, between GDIH and mild-moderate DIH （MMDIH）, and between GDIH and SDIH （t=-3.412, -4.432, -4.578, -3.908, -2.823; P 〈 0.05）. The ratio of Treg in MMDIH, SDIH and GDIH was significantly increased, and the differences were all significant between the control group and any other groups （t=-3.502, -5.055, -5.028; P 〈 0.05）; The ratio of Th17/Treg in SDIH and GDIH was significantly increased, and the differences were all significant between the control group and SDIH, between the control group and GDIH, and between GDIH and MMDIH （t=-2.574, -4.513, -4.225; P 〈 0.05）. 2. The value of Th 17 and Th17/Treg were significantly positive correlated with Tbil, PT separately （P 〈 0.05）. 3. The ratios of Thl7 and Thl7/Treg in deteriorated group were significantly higher than improved group, and the differences were all significant （t=-8.068, -2.309; P 〈 0.05）. Conclusion There was different degree of immune dysfunction in SDIH and GDIH. The ratios of Thl 7 and Thl7/Treg are associated with disease progression, and has important value to the prognosis of patients.

关 键 词：药物性肝炎 TH17 Treg TH17/TREG 

分 类 号：R575.1[医药卫生—消化系统]