非酒精性脂肪性肝病患者病情进展与T细胞水平的相关性研究  

Correlation between disease progression and levels of T cells in patients with non-alcoholic fatty liver disease

作　　者：李阳[1] 杜志祥 王牧婷 刘璐阳 肖丽[1] 窦宇明[1] 庞晓鹰 LI Yang;DU Zhixiang;WANG Muting;LIU Luyang;XIAO Li;DOU Yuming;PANG Xiaoying(Department of Liver Disease,Taizhou City People′s ospital,Taizhou,Jiangsu,225300)

机构地区：[1]江苏省泰州市人民医院肝病科,江苏泰州225300

出　　处：《实用临床医药杂志》2020年第14期11-14,18,共5页Journal of Clinical Medicine in Practice

基　　金：江苏省泰州市科技项目(TF201928);江苏省泰州市人民医院院级项目(ZL201922)。

摘　　要：目的探讨非酒精性脂肪性肝病(NAFLD)患者病情进展与辅助性T细胞17(Th17)、调节性T细胞(Treg)水平的相关性。方法选取非酒精性脂肪性肝炎(NASH)患者、非酒精性脂肪肝(NAFL)患者以及健康对照者各25例,比较3组肝脏病变程度相关指标[丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)、总胆红素(TBil)、直接胆红素(DBil)]、肝纤维化4项[Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)、层黏连蛋白(LN)、透明质酸酶(HA)],分析外周血Th17、Treg及相关炎症因子[白细胞介素-10(IL-10)、白细胞介素-17(IL-17)]与肝脏病变程度相关性。结果3组患者年龄、性别分布、吸烟史、高血压病、肝硬化家族史比较差异无统计学意义(P>0.05);对照组合并糖尿病者7例,显著少于NAFL组18例和NASH组19例(P<0.05)。3组外周血Th17、Treg、IL-10、IL-17水平两两比较,差异均有统计学意义(P<0.05)。NASH组ALT、AST水平显著高于其他2组(P<0.05);NAFL组ALT水平显著低于对照组(P<0.05),AST水平显著高于对照组(P<0.05)。NASH组TBil、DBil水平与NAFL组、对照组比较均差异有统计学意义(P<0.05)。NASH组PCⅢ、Ⅳ-C、LN、HA水平以及Fibro-touch评分均显著高于其他2组(P<0.05),且NAFL组HA水平显著高于对照组(P<0.05)。相关性分析结果显示,Th17、IL-17与ALT、AST、TBil、DBil、PCⅢ、Ⅳ-C、LN、HA、Fibro-touch评分、病情程度呈显著正相关(P<0.001),Treg、IL-10与ALT、AST、TBil、DBil、PCⅢ、Ⅳ-C、LN、HA、Fibro-touch评分、病情程度呈显著负相关(P<0.001)。结论NAFLD患者外周血中Th17/Treg比例失衡,Th17、Treg表达水平与病情严重程度高度相关,可作为评估NAFLD病情进展的有效指标。Objective To explore the correlation between the disease progression and the levels of T helper type 17(Th17)cells,regulatory T(Treg)cells in patients with non-alcoholic fatty liver disease(NAFLD).Methods A total of 25 patients with non-alcoholic fatty liver(NAFL),25 cases with non-alcoholic fatty hepatitis(NAFSH)and 25 healthy controls were selected,The indexes related to liver lesions in the three groups[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBil),direct bilirubin(DBil)],and four indicators of liver fibrosis[procollagenⅢ(PCⅢ),typeⅣcollagen(Ⅳ-C),laminin(LN),and hyaluronidase(HA)]of the three groups were compared,and correlations between Th17,Treg cells as well as related inflammatory factors[Interleukin-10(IL-10),interleukin-17(IL-17)]and degree of liver fibrosis were analyzed.Results There were no significant differences in age,sex distribution,smoking history,hypertension and family history of cirrhosis among the three groups(P>0.05).The number of patients with diabetes in the control group was seven cases,which was significantly lower than 18 cases in the NAFL group and 19 in the NASH group(P<0.05).The levels of Th17,Treg,IL-10 and IL-17 in peripheral blood showed significant between-group differences(P<0.05).The levels of ALT and AST in the NASH group were significantly higher than those in the other two groups(P<0.05).ALT level in the NAFL group was significantly lower(P<0.05),and AST level in the NAFL group was significantly higher than that in the control group(P<0.05).The levels of TBil and DBil in the NASH group showed significant differences compared to the NAFL group and the control group(P<0.05).The levels of PCⅢ,Ⅳ-C,LN,HA and fibro-touch score in the NASH group were significantly higher than those in the other two groups(P<0.05),and HA level in the NAFL group was significantly higher than that in the control group(P<0.05).The results of correlation analysis showed that ALT,AST,TBil,DBil,PCⅢ,Ⅳ-C,LN,HA,fibro-touch score,and degree of disease had

关 键 词：非酒精性脂肪性肝病 非酒精性脂肪性肝炎 非酒精性脂肪肝 辅助性T细胞 调节性T细胞 病情进展 相关性 

分 类 号：R575.5[医药卫生—消化系统]