自身免疫性肝炎患者肝内程序性死亡受体1高表达与肝脏炎症活动相关  

Association between high expression of intrahepatic programmed death-1 and liver inflammation in patients with autoimmune hepatitis

作　　者：熊克宫[1] 柯坤宇[1] 陈丽芳[1] 魏大海[1] 林小钦[1] 陈立[1] 

机构地区：[1]福建医科大学孟超肝胆医院(福州市传染病医院)肝病科,福州350025

出　　处：《中华肝脏病杂志》2017年第4期263-267,共5页Chinese Journal of Hepatology

基　　金：福州市卫生系统科技计划项目（2016-S-wq7,2014-S-w21）

摘　　要：目的研究自身免疫性肝炎（AIH）患者肝组织中程序性死亡受体1（PD-1）的表达情况，并探讨其与肝脏病理的相关性。方法收集54例AIH患者（活动期38例和缓解期16例），并选择9例健康者为对照组。采用免疫组织化学方法结合图像定量分析系统检测肝组织中PD-1的表达。据资料不同分别采用t检验、秩和检验、单因素方差分析及LSD-t检验、Mann-Whitney U及Pearson相关分析进行统计学分析。结果AIH患者肝组织PD-1阳性表达率高于对照组（13．57％±6．84％对比2．22％±0．66％，P〈0．01）；AIH活动期肝组织PD-1阳性表达率高于缓解期（16．53％土7．72％对比6．56％±3．16％，P〈0．01）。G0组、G1-2组及G3-4组AIH患者肝组织中PD-1阳性表达率逐渐升高，分别为6．56％±3．16％、14．33％±5．08％、19．23％±5．41％（P〈0．01），而S0组、S1-2组及S3-4组AIH患者肝组织中PD-1阳性表达率则无差异（P〉0．05）。AIH患者肝组织PD-1阳性表达率与总胆红素、丙氨酸氨基转移酶、天冬氨酸氨基转移酶及IgG水平均呈正相关（r分别是0．665、0．721、0．711、0．813，P〈0．01）。结论AIH患者肝组织PD-1表达上调，与肝组织炎症活动密切相关，但与纤维化分级无相关性，提示PD-1参与了AIH炎症的发生及发展。Objective To investigate the expression of programmed death-1 （PD-1） in liver tissue and its association with liver pathology in patients with autoimmune hepatitis （AIH）. Methods A total of 54 AIH patients （38 in the active stage and 16 in the remission stage） were enrolled, and 9 healthy volunteers were enrolled as control group. Immunohistoehemistry combined with quantitative image analysis was used to measure the expression of PD-1 in liver tissue. The t-test, rank sum test, one-way analysis of variance, least significant difference t-test, Mann-Whitney U test, and Pearson relation analysis were used for statistical analysis of different types of data. Results The AIH group had a significantly higher positive rate of PD- 1 in liver tissue than the control group （13.57%±6.84% vs 2.22%±0.66%, P 〈 0.01）, and the patients in the active stage of AIH had a significantly higher positive rate of PD-1 in liver tissue than those in the remission stage （16.53%±7.72% vs 6.56%±3.16%,P 〈 0.01）. The positive rate of PD-1 in liver tissue was 6.56%±3.16% in GO group, 14.33%±5.08% in G1-2 group, and 19.23%±5.41% in G3-4 group （P 〈 0.01）, but there was no significant difference in the positive rate of PD-1 between SO, S1-2, and S3-4 groups （P〉 0.05）. InAIH patients, the positive rate of PD-1 in liver tissue was positively correlated with the levels of total bilirubin, alanine aminotransferase,aspartate aminotransferase, and IgG （1- = 0.665, 0.721, 0.711, and 0.813, all P 〈 0.01）. Conclusion AIH patients have regulated PD-1 expression in liver tissue, which is closely associated with liver inflammation and is not associated with fibrosis degree, suggesting that PD-1 is involved in the development and progression of inflammation in AIH patients.

关 键 词：肝炎 自身免疫性 程序性死亡受体l 病理学 肝组织 

分 类 号：R575.1[医药卫生—消化系统]