乙型肝炎肝硬化患者外周血调节性T细胞频率及其分泌转化生长因子-β的动态变化及意义  

Dynamic Changes and Significance of Regulatory T Cell Frequency and Transforming Growth Factor-β Secretion from Treg Cells in Peripheral Blood of Patients with Hepatitis B Cirrhosis

作　　者：刘阳[1] 胡裕书 董建霞 闫婧雅[1] 李志勤[1] LIU Yang;HU Yushu;DONG Jianxia;YAN Jingya;LI Zhiqin(Department of Infectious Diseases,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院感染科,河南郑州450052

出　　处：《河南医学研究》2022年第7期1183-1188,共6页Henan Medical Research

基　　金：2021和2022年河南省医学科技攻关省部共建青年项目(SBGJ202102085)。

摘　　要：目的探讨乙型肝炎肝硬化患者外周血调节性T(Treg)细胞分布频率及其分泌的转化生长因子-β(TGF-β)在治疗前后的变化及临床意义。方法选取2015年1月至2018年3月在郑州大学第一附属医院感染科住院的215例乙肝表面抗原(HBsAg)阳性的慢性HBV感染者,后将经病理诊断为肝硬化的82例患者纳入治疗组。同时收集临床诊断为慢性HBsAg携带者80例(HBsAg携带组)及80名门诊体检健康者(健康对照组)的外周血标本。根据谷丙转氨酶(GPT)水平将治疗组患者分为GPT正常组(GPT≤40U·L^(-1))和GPT异常组(GPT>40U·L^(-1))。测定所有研究对象的外周血Treg细胞及其分泌的TGF-β量。监测治疗组患者治疗基线、治疗48周、治疗96周的外周血Treg细胞及其分泌TGF-β量的变化。结果3组Treg细胞频率、TGF-β比较,差异有统计学意义(P<0.05);与健康对照组比较,HBsAg携带组、治疗组外周血Treg细胞频率及其分泌的TGF-β比值均较高(P<0.05);与HBsAg携带组比较,治疗组外周血Treg细胞频率及其分泌的TGF-β比值均较高(P<0.05)。GPT异常组外周Treg细胞频率及其分泌的TGF-β比值均较GPT正常组低(P<0.05)。与治疗基线比较,随着治疗时间的延长,GPT、谷草转氨酶(GOT)、HBVDNA水平以及TGF-β比值逐渐下降(P<0.05);治疗48周和治疗96周的Treg细胞频率均低于治疗基线时(P<0.05);治疗96周的Treg细胞频率与治疗48周时比较,差异无统计学意义(P>0.05)。治疗组患者治疗基线和治疗96周的外周血Treg细胞频率、TGF-β比值与肝脏纤维化分期均呈正相关(P<0.05)。治疗96周时,治疗组患者肝脏炎症及纤维化均较治疗基线时有所改善(P<0.05)。结论外周血Treg细胞及其分泌TGF-β的情况可被作为评价乙型肝炎肝硬化患者治疗后肝脏炎症及纤维化改善程度的生物学指标。Objective To investigate the changes before and after treatment and clinical significance of the distribution frequency of regulatory T(Treg)cells and transforming growth factor-β(TGF-β)secretion from Treg cells in patients with with hepatitis B cirrhosis.Methods Two hundred and fifteen hepatitis B surface antigen(HBsAg)-positive patients with chronic HBV infection in the Department of Infectious Diseases of the First Affiliated Hospital of Zhengzhou Uni versity from January 2015 to March 2018 were cllecte.e After that,82 patients diagnosed as liver cirhosis by pathology were included in treatment group.At the same time,the peripheral blood samples of 80 clinically di agnosed chronie HBsAg carriers(HBsAg carrier group)and 80 healthy people(healthy control group)were collected.According to the level of glutamic-pyruvic transaminase(GPT),the patients in the treatment group were divided into normal GPT group(GPT≤40U.L^(-1))and abnormal GPT group(GPT>40U.L^(-1)).Treg cells in peripheral blood of all subjects and the amount of TGF-β secreted by them were measured.The changes of Treg cells and TGF-β secretion in peripheral blood of patients in treatment group were monitored at baseline,48 weeks and 96 weeks after treatment.Results There were stastistical differences in the frequency of Treg cells and TGF-β among the three groups(P<0.05).Compared with healthy control group,the frequency of Treg cells in peripheral blood and the ratio of TGF-β secreted by Treg cells in HBsAg carrier group and treatment group were higher(P<0.05).Compared with HBsAg carrier group,Treg cell frequencies and TGF-β ratio in peripheral blood of treatment group were higher(P<0.05).The frequeney of peripheral Treg cells and the ratio of TGF-β secreted by Treg cells in abnormal GPT group were lower than those of normal GPT group(P<0.05).Compared with the baseline,the levels of GPT,glutamic-oxaloacetic transaminase(GOT),HBV DNA and TGF-β ratio gradually decreased with the prolongation of treatment time(P<0.05).The frequencirs of Treg cel

关 键 词：乙型肝炎 肝硬化 调节性T细胞 转化生长因子-Β 

分 类 号：R575.29[医药卫生—消化系统]