自身免疫性肝炎患者外周血NKp46^(+)ILC3细胞和Th17细胞变化及其临床意义探讨  

Changes of peripheral blood NKp46^(+) ILC3 cells and Th17 cells in patients with autoimmune hepatitis

作　　者：王浩宇 周娟燕 刘茹 徐菁 马少君[4] Wang Haoyu;Zhou Juanyan;Liu Ru(Department of Gastroenterology,3201 Hospital,Hanzhong 723000,Shaanxi Province,China)

机构地区：[1]陕西省汉中市三二〇一医院消化内科,723000 [2]陕西省汉中市三二〇一医院康复医学科,723000 [3]安徽医科大学第四附属医院消化内科 [4]陕西省人民医院医学影像科

出　　处：《实用肝脏病杂志》2023年第1期39-42,共4页Journal of Practical Hepatology

基　　金：陕西省科技厅重点研发项目(编号:2020-SF-056)

摘　　要：目的研究自身免疫性肝炎(AIH)患者外周血NKp46^(+)ILC3细胞和Th17细胞百分比变化及其临床意义.方法2016年2月~2020年2月我院收治的AIH患者43例,使用流式细胞仪检测外周血NKp46^(+)3型天然淋巴样细胞(ILC3)和Th17细胞百分比,应用受试者工作特征曲线(ROC)下面积(AUC)分析应用NKp46^(+)ILC3细胞和Th17细胞百分比判断AIH患者肝组织炎症活动分级的效能.结果10例临床重度AIH患者NKp46^(+)ILC3细胞和Th17细胞百分比分别为(0.2±0.2)%和(1.3±0.4)%,显著低于或高于33例轻中度AIH患者[分别为(0.5±0.2)%和(0.8±0.3)%,P<0.05];12例肝组织G3~4级AIH患者NKp46^(+)ILC3细胞百分比和Th17细胞百分比分别为(0.3±0.2)%和(1.3±0.4)%,显著低于或高于31例G1~2级AIH患者[分别为(0.5±0.2)%和(0.8±0.3)%,P<0.05];以外周血NKp46^(+)ILC3细胞百分比≤0.3%为截断点,判断AIH患者肝组织炎症重度活动的AUC为0.774(95%CI:0.592~0.957),其敏感度为75.0%,特异度为87.1%;以外周血Th17细胞百分比>1.1%为截断点,判断AIH患者肝组织炎症重度活动的AUC为0.853(95%CI:0.734~0.973),其敏感度为66.7%,特异度为90.3%.结论AIH患者外周血NKp46^(+)ILC3细胞水平降低,而Th17细胞水平升高.应用这种变化规律可能有助于判断AIH患者肝组织炎症活动分级,对评估AIH患者病情具有一定的临床意义.Objective The aim of this study was to explore the implications of peripheral blood NKp46^(+)ILC3 cells and Th17 cells in patients with autoimmune hepatitis(AIH).Methods 43 patients with AIH were encountered in our hospital between February 2016 and February 2020.The percentages of peripheral blood NKp46^(+)ILC3 and Th17 positive mononuclear cells were detected by flow cytometry,and the area under receiver operating characteristic(ROC)curve(AUC)was adopted to analyze the efficacy of NKp46^(+)ILC3 cells and Th17 cells in judging the liver histological activity grading in patients with AIH.Results The percentages of NKp46^(+)ILC3 cells and Th17 cells in 10 patients with severe AIH were(0.2±0.2)%and(1.3±0.4)%,significantly lower or higher than[(0.5±0.2)%and(0.8±0.3)%,respectively,P<0.05]in 33 patients with mild to moderate AIH;the percentages of NKp46^(+)ILC3 cells and Th17 cells in 12 AIH patients with liver histological activity G3 to G 4 were(0.3±0.2)%and(1.3±0.4)%,significantly lower or higher than[(0.5±0.2)%and(0.8±0.3)%,respectively,P<0.05]in 31 AIH patients with G1 to G2;the AUC was 0.774(95%CI:0.592-0.957),with the sensitivity(Se)of 75.0%and specificity(Sp)of 87.1%when the peripheral blood NKp46^(+)ILC3 cells≤0.3%was set as the cut-off-value,and the AUC was 0.853(95%CI:0.734-0.973),with Se of 66.7%and Sp of 90.3%when the peripheral blood Th17 cells>1.1%was set as the cut-off-value in judging severe liver histological activity grading.Conclusion The peripheral blood NKp46^(+)ILC3 cells decrease,and that of Th17 cells increase in patients with AIH,and application of them might help judge the liver histological activity changes.

关 键 词：自身免疫性肝炎 NKp46+ILC3细胞 TH17细胞 临床意义 

分 类 号：R575.1[医药卫生—消化系统]