乙型肝炎肝硬化并发自发性细菌性腹膜炎患者CD64指数及血清sTREM-1和IL-6水平变化与肠黏膜屏障功能关系研究  

Correlation of blood CD64 index to intestinal mucosal barrier functions in patients with hepatitis B cirrhosis and spontaneous bacterial peritonitis

作　　者：王菁 毕宁[1] 方亮[1] 田园 Wang Jing;Bi Ning;Fang Liang(Department of Gastroenterology,Central Hospital,Huanggang 438000,Hubei Province,China)

机构地区：[1]湖北省黄冈市中心医院消化内科,438000 [2]华中科技大学同济医学院武汉市中心医院内科

出　　处：《实用肝脏病杂志》2022年第1期79-82,共4页Journal of Practical Hepatology

摘　　要：目的探讨乙型肝炎肝硬化并发自发性细菌性腹膜炎(SBP)患者外周血簇分化抗原64(CD64)指数、血清可溶性髓样细胞触发受体-1(sTREM-1)和白细胞介素-6(IL-6)水平变化及其与肠黏膜屏障功能的相关性。方法2015年10月~2020年2月我院收治的失代偿期乙型肝炎肝硬化患者86例,其中并发SBP患者54例。使用流式细胞仪检测外周血CD64+细胞百分比,并根据中性多形核白细胞、淋巴细胞和单核细胞平均荧光强度计算CD64指数,采用ELISA法检测血清sTREM-1和IL-6水平,检测血清内毒素(EXT)和尿甘露醇/乳果糖,计算其比值(L/M)评判肠黏膜屏障功能。结果治疗前,乙型肝炎肝硬化并发SBP患者血清IL-6、sTREM-1、D-Lac、DAO、EXT及CD64指数和L/M比值分别为(122.1±37.9)ng/L、(60.3±12.4)μg/mL、(5.1±1.6)μg/mL、(14.2±2.2)μg/mL、(0.2±0.0)U/mL及(12314.3±324.3)mol/cell和(0.2±0.1),均显著高于乙型肝炎肝硬化患者【分别为(78.6±28.2)ng/L、(51.4±10.6)μg/mL、(2.5±0.8)μg/mL、(9.8±1.6)μg/mL、(0.1±0.0)U/mL及(6376.52.5±0.3)mol/cell和(0.1±0.0),均P<0.05】;治疗后,SBP患者血清IL-6、sTREM-1、D-Lac、DAO、EXT及CD64指数和L/M比值分别为(71.2±23.9)ng/L、(17.5±5.1)μg/mL、(2.9±0.8)μg/mL、(14.2±2.2)μg/mL、(0.1±0.0)U/mL及(3398.2±258.2)mol/cell和(0.1±0.0),仍显著高于乙型肝炎肝硬化患者【分别为(52.1±21.6)ng/L、(10.8±2.5)μg/mL、(2.3±0.5)μg/mL、(8.7±1.2)μg/mL、(0.0±0.0)U/mL及(2541.0±266.2)mol/cell和(0.0±0.0),均P<0.05】;治疗后,33例肠粘膜功能障碍的SBP患者血清IL-6和sTREM-1水平及外周血CD64指数为(75.2±24.1)pg/mL和(19.5±4.9)μg/mL及(3642.2±242.1)mol/cell,显著高于21例肠粘膜功能正常患者【分别为(65.2±21.3)pg/mL和(14.8±4.3)μg/mL及(3123.2±168.4)mol/cell,P<0.05】。结论乙型肝炎肝硬化并发SBP患者存在肠粘膜屏障功能障碍,可能对SBP的发生起了关键作用。Objective The aim of this study was to explore the correlation of blood cluster differentiation(CD)antigen 64(CD64)index,serum soluble triggering receptor expressed on myeloid cells-1(sTREM-1)and interleukin-6(IL-6)levels to intestinal mucosal barrier functions in patients with hepatitis B liver cirrhosis(LC)and spontaneous bacterial peritonitis(SBP).Methods Eighty-six cirrhotics were admitted to our hospital between October 2015 and February 2020,and fifty-four had SBP.The peripheral blood CD64 positive polymorphonuclear neutrophils,lymphocytes and monocytes were detected by flow cytometry and CD64 index was calculated automatically.Serum sTREM-1 and IL-6 levels were detected by ELISA.Blood endotoxin(ETX)and urine lactulose/mannitol(L/M)ratio were detected and calculated to determine intestinal mucosal barrier functions.Results At presentation,serum IL-6,sTREM-1,D-Lac,DAO,EXT as well as blood CD64 index and urine L/M ratio in patients with SBP were(122.1±37.9)ng/L,(60.3±12.4)μg/mL,(5.1±1.6)μg/mL,(14.2±2.2)μg/mL,(0.2±0.0)U/mL as well as(12314.3±324.3)mol/cell and(0.2±0.1),all significantly higher than[(78.6±28.2)ng/L,(51.4±10.6)μg/mL,(2.5±0.8)μg/mL,(9.8±1.6)μg/mL,(0.1±0.0)U/mL as well as(6376.52.5±0.3)mol/cell and(0.1±0.0),respectively,all P<0.05]in LC patients without SBP;after treatment,serum IL-6,sTREM-1,D-Lac,DAO,EXT as well as CD64 index and urine L/M ratio in patients with SBP were(71.2±23.9)ng/L,(17.5±5.1)μg/mL,(2.9±0.8)μg/mL,(14.2±2.2)μg/mL,(0.1±0.0)U/mL as well as(3398.2±258.2)mol/cell and(0.1±0.0),also all significantly higher than[(52.1±21.6)n g/L,(10.8±2.5)μg/mL,(2.3±0.5)μg/mL,(8.7±1.2)μg/mL,(0.0±0.0)U/mL as well as(2541.0±266.2)mol/cell and(0.0±0.0),respectively,all P<0.05]in cirrhotics without SBP;after treatment,serum IL-6 and sTREM-1 levels as well as blood CD64 index in 33 SBP patients with disabled intestinal mucosal barrier functions were(75.2±24.1)pg/mL and(19.5±4.9)μg/mL as well as(3642.2±242.1)mol/cell,all significantly higher than[(65.2±21.3)pg/m

关 键 词：肝硬化 自发性细菌性腹膜炎 CD64指数 可溶性髓样细胞触发受体-1 白细胞介素-6 肠粘膜屏障功能 

分 类 号：R512.62[医药卫生—内科学] R572.2[医药卫生—临床医学]