TIPS治疗对肝硬化门脉高压患者Treg/Th17比例影响及作用机制研究  

Effect of TIPS on Treg/Th17 ratio in patients with cirrhosis and portal hypertension and its mechanism

作　　者：马存凯[1] 孙世蒙 于海东[1] 杨海明[1] 马俊[1] 郭应兴[1] MA Cunkai;SUN Shimeng;YU Haidong;YANG Haiming;MA Jun;GUO Yingxing(Department of Interventional Radiology,the Affiliated Hospital of Qinghai University,Xining 810001,China)

机构地区：[1]青海大学附属医院介入科,青海西宁810001

出　　处：《实用放射学杂志》2020年第2期281-284,共4页Journal of Practical Radiology

基　　金：青海省卫生和计划生育委员会医药卫生科技项目(2017GwjzdxG62).

摘　　要：目的研究经颈静脉肝内门体分流术(TIPS)治疗肝硬化门脉高压(PHT)前后调节性T细胞(Treg)/辅助性T细胞17(Th17)比例的变化及TIPS缓解门脉高压性的作用机制.方法本研究选取行TIPS治疗PHT的9例患者作为治疗组,内科保守治疗的PHT 8例患者作为对照组,分析2组Treg/Th17比例及缺氧诱导因子1α(HIF-1α)的水平变化.结果2组患者Treg/Th17相关因子比较均无统计学差异(P>0.05),治疗组中叉头蛋白P3(FOXP3)、IL-17A术后3月与术前比较有统计学差异(P<0.05).HIF-1α2组术前比较无统计学差异(P>0.05),术后3月比较有统计学差异(P<0.05),治疗组术后3月与术前比较有统计学差异(P<0.05).结论TIPS治疗PHT通过降低门脉压力来缓解脾脏及胃肠道微环境的缺氧情况导致Treg/Th17分化改变来起到调控门脉高压相关性炎症反应的作用.Objective To study the change of regulatory T cell(Treg)/helper T cell 17(Th17)ratio before and after transijugular intrahepatic portosystemic shunt(TIPS)treatment of portal hypertension(PHT)and the related mechanism of TIPS in alleviating portal hypertension-related complications.Methods In this study,9 cases of patients with PHT due to cirrhosis who received TIPS treatment were selected as the experimental group,and 8 cases of patients with PHT due to cirrhosis who received conservative treatment in internal medicine were selected as the control group.The Treg/Th17 and the level of hypoxia-inducible factor la(HIF-1α)in the two groups were analyzed.Results There was no statistically significant difference in Treg/Th17 related factors between the two groups(P>0.05),but there was statistically significant difference in FOXP3 and IL-17A between the two groups 3 months after operation and before operation(P<0.05).There was no statistically significant difference in HIF-la between the two groups before operation(P>0.05),and there was statistically significant difference between the two groups 3 months after operation(P<0.05),and there was statistically significant difference between the two groups 3 months after operation and before operation(P<0.05).Conclusion TIPS treatment of PHT in cirrhosis can alleviate the hypoxia of the spleen and gastrointestinal microenvironment by reducing portal pressure,which leads change of Treg/Th17 differentiation,which plays a role in regulating the inflammatory response associated with portal hypertension.

关 键 词：肝硬化门脉高压 调节性T细胞 辅助性T细胞17 缺氧诱导因子1Α 经颈静脉肝内门体分流术 

分 类 号：R575.21[医药卫生—消化系统] R815[医药卫生—内科学]