摘要
目的观察慢加急性肝功能衰竭(ACLF)患者血清中巨噬细胞刺激蛋白(MSP)水平,并探讨其在疾病进展过程中的临床意义及其与免疫调节因子的相关性。方法双抗原夹心ELISA法检测45例ACLF和32例CHB患者血清MSP水平,比较不同预后ACLF患者的MSP水平。以健康体检者作为对照。同时测定肝功能、HBVDNA,流式细胞仪检测外周血CD4^+γ干扰素^+(Th1)、CD4^+IL-4^+(Th2)、CD4^+IL-17^+(Th17)、CD4^+CD25^+Foxp3^+(Treg)淋巴细胞的表达。两样本均数比较采用t检验,并行单因素方差分析和直线相关分析。结果ACLF组血清MSP为(1.65±0.46)ng/mL,CHB组为(1.43±0.32)ng/mL,健康对照组为(1.23±0.21)ng/mL,ACLF组高于CHB组(t=2.163,P=0.035)和健康对照组(t=4.032,P=0.01)。ACLF存活组MSP水平为(2.29±0.42)ng/mL,高于死亡组的(1.42±0.17)ng/mL(t=1.973,P=0.042)。ACLF组外周血Th2、Th17分别为(1.51±0.27)%和(1.94±1.02)%,CHB组为(0.42±0.08)%和(0.055±0.36)%,健康对照组为(0.23±0.19)%和(0.26±0.19)%,差异均有统计学意义(F值分别为7.759和37.229,均P〈0.01)。MSP水平与Th2(r=0.386,P=0.032)、Th17(r=0.644,P=0.000)和Th17/Treg比值(r=0.605,P=0.000)呈正相关,与Th1(r=-0.212)、Treg(r=-0.262)和Th1/Th2比值(r=-0.394)无相关性(均P〉0.05)。结论MSP参与ACLF病程进展过程,且与ACLF的临床转归和患者细胞免疫水平失衡有一定关系。
Objective To observe the expression level of macrophage stimulating protein (MSP) in acute-on-chronic liver.failure (ACLF) patients, and to explore the clinical significance and correlation with different immune regulatory factors. Methods The double antigen sandwich enzyme-linked immunosorbent assay method was used to detect MSP in the peripheral blood of 45 patients who were diagnosed with ACLF and 32 cases of chronic hepatitis B (CHB). The MSP levels were compared among ACLF patients with different outcomes, and the MSP level of healthy person was used as control. Meanwhile, liver function and hepatitis B virus (HBV) load were detected, and the expressions of peripheral blood CD4^+ interferon (IFN)γ^+ (helper T cell 1 Th1), CD4^+ interleukin (IL)-4T^+ (helper T cell 2, Th2), CD4^+ IL-17+ (helper T cell 17, Th1T) and CD4^+ CD25^+ Foxp^3+ (regular T cell, Treg) were measured by flow cytometry. The comparison of means between two samples was done by t test, and oneway ANOVA and linear correlation analysis were also used. Results The serum MSP levels in ACLF patients ,CHB group and healthy control were (1.65±0.46) ng/mL, (1.43±0.32) ng/mL and (1.23±0.21) ng/mL, respectively. The serum MSP level in ACLF patients was significantly higher than both CHB patients (t=2. 163, P=0. 035) and healthy control (t=4. 032, P=0.01). The MSP level in ACLF survival group was statistically higher compared with ACLF death group ([2.29 ±0.42] ng/mL vs [1.42 ± 0.17] ng/mL, t=1. 973, P=0. 042). Th2, Th17 cells in ACLF group, CHB group and healthy control group were (1.51±0.27)% and (1.94±1.02)%, (0.42±0.08)%and (0.55±0.36)%, (0.23 ±0. 19) %, and (0.26±0.19) %, respectively, which were all significantly different (F= 7. 759 and 37. 229, respectively; both P〈0.01). The MSP level was positively associated with the number of Th2 (r=0. 386, P=0. 032 ) and Th17 (r=0. 644, P=0.000), and the ratio of Th17/Treg (
出处
《中华传染病杂志》
CAS
CSCD
北大核心
2016年第2期80-83,共4页
Chinese Journal of Infectious Diseases
基金
国家“十二五”科技重大专项(2012ZX10002004-008)
江苏省自然科学青年基金(BK20130271)
天晴肝病研究基金(TQGB20150026)
关键词
慢加急性肝功能衰竭
巨噬细胞刺激蛋白
免疫
细胞
Acute-on-chronic liver failure Macrophage stimulating protein Immunity, cellular