T、B淋巴细胞自噬在自身免疫性肝炎患者外周血中的表达及临床意义  

Expression of autophagy marker in peripheral blood T and B lymphocytes of patients with autoimmune hepatitis and its clinical significance

作　　者：伍慧丽[1] 时红波[1] 刘燕敏[1] 严艳[1] 王玲玲 丁美[1] 马正来 刘晖[1] 段钟平[1] WU Huili;SHI Hongbo;LIU Yanmin;YAN Yan;WANG Lingling;DING Mei;MA Zhenglai;LIU Hui;DUAN Zhongping(Department of Hepatology,Beijing YouAn Hospital,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京佑安医院肝病科,北京100069

出　　处：《临床肝胆病杂志》2022年第11期2483-2487,共5页Journal of Clinical Hepatology

基　　金：大数据精准医疗高精尖创新中心(PXM2021-014226-000026);首都卫生发展科研专项项目(2021-1G-2181);首都医科大学附属北京佑安医院中青年人才孵育项目(YNKTQN2021008)。

摘　　要：目的探讨自身免疫性肝炎(AIH)患者外周血T、B淋巴细胞自噬表达及其临床意义。方法选取2019年10月—2020年10月在首都医科大学附属北京佑安医院门诊或住院治疗的62例AIH患者及8例健康对照者外周血进行T、B淋巴细胞亚群自噬相关检测,根据治疗情况、诊断类型、是否合并肝硬化及肝衰竭进行分组分析。符合正态分布的计量资料两组间比较采用t检验,非正态分布计量资料多组间比较采用Kruskal-Wallis H检验,两组间比较采用Mann-Whitney U检验;计数资料组间比较采用χ^(2)检验或Fisher精确概率法。结果AIH组CD4^(+)T、CD8^(+)T、CD19^(+)B及CD4^(+)CD25^(+)T淋巴细胞自噬LC3B平均荧光强度(MFI)均显著高于健康对照组(P值均<0.05),以CD19^(+)B淋巴细胞自噬LC3B MFI最显著。CD19^(+)B淋巴细胞自噬MFI在未治疗组和治疗部分缓解组中高于治疗完全缓解组(P值分别为0.037、0.040),在特发性AIH组(I-AIH)和药物诱导的AIH组(DI-AIH)高于重叠综合征组(PBC-AIH)(P值分别为0.037、0.031),在无肝硬化组和失代偿期肝硬化组高于代偿期肝硬化组(P值分别为0.009、0.003),在肝衰竭组中高于无肝衰竭组(P=0.042);CD4^(+)CD25^(+)T淋巴细胞自噬MFI在PBC-AIH组高于I-AIH组和DI-AIH组(P值分别为0.042、0.044),在代偿期肝硬化组低于无肝硬化组(P=0.037),无肝衰竭组中高于肝衰竭组(P=0.043)。结论AIH患者较健康人外周血T、B淋巴细胞亚群自噬表达升高,其自噬水平与治疗、诊断类型、疾病严重程度有关。Objective To investigate the expression of autophagy marker in peripheral blood T and B lymphocytes of patients with autoimmune hepatitis(AIH)and its clinical significance.Methods Peripheral blood samples were collected from 62 AIH patients who were treated in Beijing YouAn Hospital affiliated to Capital Medical University from October 2019 to October 2020 who were treated in Beijing YouAn Hospital affiliated to Capital Medical University from October 2019 to October 2020 and 8 healthy controls to detect autophagy of T and B lymphocyte subsets,and then subgroup analyses were performed based on treatment,diagnostic type,and presence or absence of liver cirrhosis and liver failure.The t-test was used for comparison of normally distributed continuous data between two groups;the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups,and the Mann-Whitney U test was used for comparison between two groups;the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups.Results Compared with the healthy control group,the AIH group had a significantly higher mean fluorescence intensity(MFI)of the autophagy marker LC3B in CD4^(+)T,CD8^(+)T,CD19^(+)B,and CD4^(+)CD25^(+)T lymphocytes(all P<0.05),especially in CD19^(+)B lymphocytes.The non-treatment group and the partial remission group had a significantly higher MFI of autophagy marker in CD19^(+)B lymphocytes than the complete remission group(P=0.037 and 0.040);the idiopathic AIH(I-AIH)group and the drug-induced AIH(DI-AIH)group had a significantly higher MFI than the primary biliary cholangitis(PBC)-AIH overlap syndrome group(P=0.037 and 0.031);the non-cirrhosis group and the decompensated cirrhosis group had a significantly higher MFI than the compensated cirrhosis group(P=0.009 and 0.003);the liver failure group had a significantly higher MFI than the non-liver failure group(P=0.042).The PBC-AIH group had a significantly higher MFI of autophagy marker in CD4^(+)CD25^

关 键 词：肝炎 自身免疫性 淋巴细胞 自噬 

分 类 号：R575.1[医药卫生—消化系统]