自身免疫性肝炎患者65例外周血T细胞、Th1/Th2比值及肝功能检测分析  

Analysis of 65 cases of peripheral blood T cells, Th1/Th2 ratio and liver function test in patients with autoimmune hepatitis

作　　者：李巧利[1] 徐芸[1] 保洁 李胤蒴 LI Qiao-li;XU Yun;BAO Jie;LI Yin-shuo(The First Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院消化内科

出　　处：《医药论坛杂志》2019年第10期89-92,共4页Journal of Medical Forum

摘　　要：目的探讨自身免疫性肝炎(AIH)患者外周血T细胞的表达,检测外周血CD3+CD4+CRTH2-T细胞(Th1)与CD3+CD4+CRTH2+T细胞(Th2)的比值情况及肝功能的相关指标。方法选择2016年12月-2018年12月在郑州大学第一附属医院接受治疗且符合AIH临床诊断标准的患者65例进行研究作为观察组,另随机选择正常肝组织者65例作为对照组。均采取两组外周抗凝静脉血,进行分离纯化出外周血T淋巴细胞进行检测,分析外周血各类T细胞数量情况(CD3+、CD4+、CD3+CD4+T、CD3+CD8+T、CD3+CD4+T/CD3+CD8+T以及CD4+CD25+T、CD4+CD28-、CD4+CD25+T/CD4+T)。分别采用三色流式细胞术检测辅助性Th1/Th2细胞所在淋巴细胞中的百分率,同时检测两组肝功能相关指标[总胆红素(TBIL)、直接胆红素(DBIL)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、Y-谷氨酰转移酶(GGT)、总胆汁酸(TBA)]及免疫球蛋白IgG、IgM、IgA水平情况。结果经检测,观察组外周血CD4+T、CD3+CD4+T、CD3+CD8+T、CD4+CD28-比率均显著高于对照组,CD4+CD25+T小于对照组(P<0.05),但两组CD3+T、CD3+CD4+T/CD3+CD8+T、CD4+CD25+T/CD4+T相比差异无统计学意义(P>0.05)。观察组患者的Th1(22.23±6.43)%、Th2(37.85±5.54)%细胞所占比率均低于对照组[Th1(37.85±5.54)%、Th2(0.98±0.31)%],但Th1/Th2比值(56.36±5.78)%显著高于对照组[(48.93±6.26)%],差异均具有统计学意义(P<0.05)。观察组TBIL、DBIL、ALT、AST、ALP、GGT及免疫球蛋白lgG均高于对照组,TBA水平低于对照组,差异均具有统计学意义(P<0.05),但两组lgM、lgA相比差异无统计学意义(P>0.05)。结论通过对AIH患者外周血T细胞、Th1/Th2细胞及肝功能的检测分析,能够有助于阐释自身免疫性肝炎的发病机制,为治疗免疫性肝脏疾病提供新思路。Objective To investigate the expression of peripheral blood T cells in patients with autoimmune hepatitis(AIH), and to detect the ratio of peripheral blood CD3+CD4+CRTH2-T cells(Th1) to CD3+CD4+CRTH2+ T cells(Th2) and related indicators of liver function.Methods Sixty-five patients who underwent treatment in our hospital from December 2016 to December 2018 and met the AIH clinical diagnostic criteria were enrolled as the observation group, and 65 patients with normal liver tissue were randomly selected as the control group.Two groups of peripheral anticoagulated venous blood were taken to separate and purify peripheral blood T lymphocytes for analysis, and the number of T cells in peripheral blood was analyzed(CD3+, CD4+, CD3+CD4+T, CD3+CD8+T, CD3+).(CD4+T/CD3+CD8+T and CD4+CD25+T, CD4+CD28-, CD4+CD25+T/CD4+T).Three-color flow cytometry was used to detect the percentage of lymphocytes in which helper Th1/Th2 cells were located, and the liver function related indicators of total bilirubin(TBIL), direct bilirubin(DBIL), and alanine aminotransferase were detected.(ALT), aspartate aminotransferase(AST), alkaline phosphatase(ALP), Y-glutamyl transferase(GGT), total bile acid(TBA), and immunoglobulin IgG, IgM, IgA levels.Results The levels of CD4+T, CD3+CD4+T, CD3+CD8+T and CD4+CD28-in the peripheral blood of the observation group were significantly higher than those in the control group, and CD4+CD25+T was smaller than the control group(P<0.05). However, there was no significant difference between the two groups(CD>+T, CD3+CD4+T/CD3+CD8+T, CD4+CD25+T/CD4+T(P>0.05).The ratio of Th1(22.23±6.43)% and Th2(37.85±5.54)% cells in the observation group was lower than that in the control group [Th1(37.85±5.54)%, Th2(0.98±0.31)%], but Th1/Th2 The ratio(56.36±5.78)% was significantly higher than that of the control group [(48.93±6.26)%, and the difference was statistically significant(P<0.05).The TBIL, DBIL, ALT, AST, ALP, GGT and immunoglobulin lgG in the observation group were higher than those in the control group, and

关 键 词：自身免疫性 肝炎 T细胞 肝功能指标 TH1/TH2 

分 类 号：R575.1[医药卫生—消化系统]