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目的探讨乙肝慢加急性肝衰竭(HBV-ACLF)患者外周血中的Thl7、IL-17变化和意义。方法流式细胞检测术检测51例乙肝慢加急性肝衰竭患者、42例慢性乙型肝炎患者,37例乙肝肝硬化失代偿期患者,27例健康者的外周血Thl7,酶联免疫法检测其IL-17,同时分析Thl7与谷丙转氨酶和谷草转氨酶(ALT,AST)及HBV DNA载量相关性。结果 HBV-ACLF患者组的Thl7及IL-17较其他三组显著增高(P<0.05)。CHB患者组和HBV-LC患者组外周血中Thl7及IL-17较健康组显著增高(P<0.05),而CHB患者组和HBV-LC患者组之间Thl7及IL-17差别无统计学意义(P>0.05)。HBV-ACLF患者外周血Thl7与ALT(r=0.603,P<0.05)、AST(r=0.597,P<0.05)呈正相关;与HBV DNA水平无相关(r=0.356,P>0.05)。结论 Thl7及其分泌的IL-17可能促进了CHB患者的肝脏损伤及HBV-ACLF的发生及发展,有望成为HBV-ACLF患者肝脏损伤程度的免疫学指标。
Objective To investigate the significance of Th17 and IL-17 in peripheral blood of patients with chronic hepatitis B and acute liver failure (HBV-ACLF). Methods Flow cytometry was used to detect peripheral blood Thl7 in 51 patients with chronic hepatitis B and acute liver failure, 42 patients with chronic hepatitis B, 37 patients with decompensated hepatitis B and 27 healthy controls, The IL-17, at the same time analysis of Thl7 and alanine aminotransferase and aspartate aminotransferase (ALT, AST) and HBV DNA load correlation. Results The levels of Th17 and IL-17 in HBV-ACLF patients were significantly higher than those in the other three groups (P <0.05). The levels of Th17 and IL-17 in peripheral blood of CHB patients and HBV-LC patients were significantly higher than those of healthy controls (P <0.05), but there was no significant difference between Th1 7 and IL-17 in CHB patients and HBV-LC patients (P> 0.05). There was a positive correlation between Thl7 and ALT (r = 0.603, P <0.05) and AST (r = 0.597, P <0.05) in patients with HBV-ACLF and no correlation with HBV DNA (r = 0.356, P> 0.05). Conclusion Th17 and its secreted IL-17 may promote the liver injury and the occurrence and development of HBV-ACLF in patients with CHB, which is expected to be an immunological indicator of liver injury in patients with HBV-ACLF.