自身免疫性肝炎患者外周血NLR和nCD64指数变化及其临床意义探讨  

Implications of peripheral blood NLR and nCD64 index in patients with autoimmune hepatitis

作　　者：朱家瑞 葛绍锋 叶桂云 黄远茂 Zhu Jiarui;Ge Shaofeng;Ye Guiyun(Clinical Laboratory,First Hospital Affiliated to Fujian Medical University,Nanping 353000,Fujian Province,China)

机构地区：[1]福建医科大学附属南平第一医院检验科,福建省南平市353000

出　　处：《实用肝脏病杂志》2024年第5期717-720,共4页Journal of Practical Hepatology

基　　金：福建省南平市科技局科研计划研究项目(编号:N2017DY09)。

摘　　要：目的探讨自身免疫性肝炎(AIH)患者外周血中性粒细胞-淋巴细胞比值(NLR)和中性粒细胞CD64(nCD64)指数变化及其临床意义。方法2020年5月~2023年5月纳入我院收治的39例AIH患者和同期42例健康人,AIH患者接受肝活检,给予泼尼松联合硫唑嘌呤治疗。在所有受试者,常规检测血常规、血生化和免疫球蛋白G(IgG),计算NLR。使用流式细胞仪检测并计算nCD64指数。结果AIH患者血清ALT、AST和IgG及外周血NLR和nCD64指数分别为(176.0±30.2)U/L、(141.4±31.8)U/L、(19.7±2.8)g/L、(2.2±0.6)和(3.1±0.9),显著高于健康人【分别为(22.8±5.8)U/L、(27.6±6.3)U/L、(10.4±1.8)g/L、(1.4±0.2)和(0.6±0.1),P<0.05】;肝组织学检查发现轻度10例,中度17例和重度12例;G1/G2级28例,G3/G4级11例;F0期6例,F1/F2期22例,F3/F4期11例;肝组织损伤严重者血清和血液指标显著高于损伤轻者(P<0.05);在治疗6个月末,39例AIH患者获得完全生化学应答32例(82.1%),应答不完全7例(17.9%),不完全应答者NLR和nCD64分别为(1.7±0.4)和(2.1±0.6),显著高于完全应答组【分别为(1.4±0.3)和(1.5±0.5),P<0.05】。结论活动性AIH患者外周血NLR和nCD64指数升高,对评估病情和治疗应答可能有帮助,值得深入研究。Objective The aim of this study was to investigate changes of peripheral blood neutrophil-to-lymphocyte ratio(NLR)and neutrophil CD64(nCD64)index in patients with autoimmune hepatitis(AIH).Methods 39 patients with AIH and 42 healthy individuals were enrolled in our hospital between May 2020 and May 2023,and all patien ts with AIHunderwent liver biopsy and received prednisone and azathioprine combination therapy.NLR was calculated based on results of blood cytometry,and nCD64 index was detected by FCM.Serum biochemical index and immunoglobulin G(IgG)levels were routinely detected.Results Serum alanine aminotransferase,aspartate aminotransferase,IgG and peripheral blood NLR and nCD64 index in patients with AIH were(176.0±30.2)U/L,(141.4±31.8)U/L,(19.7±2.8)g/L,(2.2±0.6)and(3.1±0.9),all significantly higher than[(22.8±5.8)U/L,(27.6±6.3)U/L,(10.4±1.8)g/L,(1.4±0.2)and(0.6±0.1),respectively,P<0.05]in healthy persons;histo-pathological examination showed mild,moderate and severe disease in 10 cases,17 cases and 12 cases,G1/G2 in 28 cases and G3/G4 in 11 cases,and F0 in 6 cases,F1/F2 in 22 cases and F3/F4 in 11 cases,finding serum and blood parameters in patients with severe injuries were much higher than in those with relatively mild liver injuries(P<0.05);at end of six month treatment,complete biochemical response(CBR)was obtained in 32 cases(82.1%),and incomplete in 7 cases(17.9%),with NLR and nCD64 in patients with incomplete response of(1.7±0.4)and(2.1±0.6),much higher than[(1.4±0.3)and(1.5±0.5),respectively,P<0.05]in those with CBR.Conclusion Peripheral bloodNLR and nCD64 index in patients with active AIH elevate,which might be applied to assess disease severity and response to standard immunosuppressive therapy.

关 键 词：自身免疫性肝炎 中性粒细胞-淋巴细胞比值 中性粒细胞CD64 治疗 应答 

分 类 号：R575.1[医药卫生—消化系统]