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目的探讨外周血Th22、Th17细胞对乙型肝炎病毒(hepatitis B virus,HBV)相关性肝衰竭的预测价值。方法采用流式细胞技术检测36例HBV相关性肝衰竭患者(肝衰竭组)、29例HBV相关慢性肝炎患者(慢性肝炎组)和16例体检健康者(对照组)外周血Th22、Th17水平,计算Th17/Th22,分析外周血Th22、Th17与HBV相关性肝衰竭患者肝功能、凝血酶原时间的相关性,以及对HBV相关性肝衰竭的预测价值。结果肝衰竭组外周血Th22、Th17、Th17/Th22分别为(8.275±3.147)%、(9.542±2.507)%、1.261±0.428,慢性肝炎组分别为(5.365±1.691)%、(6.261±1.843)%、1.255±0.487,对照组分别为(2.330±1.097)%、(3.392±1.637)%、1.613±0.696,肝衰竭组、慢性肝炎组以上指标与对照组比较差异均有统计学意义(P<0.05),肝衰竭组外周血Th22、Th17水平与慢性肝炎组比较差异有统计学意义(P<0.01);肝衰竭组外周血Th22与Th17呈正相关(r=0.706,P=0.000),Th22、Th17细胞与白蛋白(r=-0.540、P=0.000,r=-0.500、P=0.000)、总胆红素(r=0.420、P=0.001,r=0.437、P=0.000)、凝血酶原时间(r=0.495、P=0.000、r=0.492、P=0.000)相关;外周血Th22、Th17预测HBV相关性肝衰竭发生的特异性、阳性预测值分别为89.7%、87.0%及93.1%、92.6%。结论 Th22、Th17在一定程度上可反映HBV相关肝脏疾病的严重程度,可作为HBV相关性肝衰竭的预测指标。
Objective To investigate the predictive value of peripheral blood Th22 and Th17 cells on hepatitis B virus (HBV) -related liver failure. Methods The levels of Th22 and Th17 in peripheral blood of 36 HBV-related liver failure patients (liver failure group), 29 HBV-related chronic hepatitis patients (chronic hepatitis group) and 16 healthy controls (control group) were detected by flow cytometry. Th17 / Th22 was calculated to analyze the relationship between Th22 and Th17 in peripheral blood and liver function and prothrombin time in patients with HBV-related liver failure, and to predict the value of HBV-related liver failure. Results The levels of Th22, Th17 and Th17 / Th22 in peripheral blood of patients with liver failure were (8.275 ± 3.147)% and (9.542 ± 2.507)%, 1.261 ± 0.428 and 5.365 ± 1.691% and 6.261 ± 1.843% %, 1.255 ± 0.487 in the control group were (2.330 ± 1.097)%, (3.392 ± 1.637)% and 1.613 ± 0.696, respectively. There were significant differences between the liver failure group and the chronic hepatitis group and the control group (P < 0.05). The levels of Th22 and Th17 in the peripheral blood of the liver failure group were significantly different from those of the chronic hepatitis group (P <0.01). The levels of Th22 and Th17 in the liver failure group were positively correlated (r = 0.706, P = 0.000) Th17 cells were significantly associated with albumin (r = -0.540, P = 0.000, r = -0.500, P = 0.000), total bilirubin (r = 0.420, P = 0.001, r = 0.437, P = 0.000) (R = 0.495, P = 0.000, r = 0.492, P = 0.000). The specific and positive predictive value of Th22 and Th17 in predicting HBV-related liver failure were 89.7%, 87.0% and 93.1% 92.6%. Conclusion Th22 and Th17, to a certain extent, can reflect the severity of HBV-related liver disease and can be used as a predictor of HBV-related liver failure.