摘要
目的探讨前列地尔联合骨化三醇改善辅助性T细胞17/调节性T细胞(T helper cell 17/T regulatory cell,Th17/Treg)失衡对原发性胆汁性肝硬化(primary biliary cirrhosis,PBC)疗效的影响。方法前瞻性纳入PBC患者200例,用随机数字表法分为对照组和研究组,对照组采取前列地尔干预治疗,研究组采取前列地尔联合骨化三醇干预治疗,分析2组临床疗效、T细胞亚群、细胞因子相关指标、Th17/Treg相关指标、肝纤维化指标、肝功能指标和不良反应发生情况。结果研究组的治疗有效率(96.0%)显著高于对照组(73.0%),χ^(2)=20.1947,P<0.05;治疗后,研究组患者表面抗原分化簇4受体(differentiation cluster 4 receptor,CD4+)、CD4+/表面抗原分化簇8受体(CD4+/differentiation cluster 8 receptor,CD4+/CD8+)、白细胞介素-2(interleukin-2,IL-2)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和白细胞介素-17(interleukin-17,IL-17)均显著降低(P<0.05),CD8+水平显著高于对照组(P<0.05);治疗后,研究组患者的Th17细胞、Treg细胞和Th17/Treg指标水平显著低于对照组(P<0.05);治疗后,研究组透明质酸酶(hyaluronidase,HA)、Ⅲ型前胶原(procollagen typeⅢ,PCⅢ)、Ⅳ型胶原(collagen typeⅣ,Ⅳ-C)和层黏连蛋白(laminin,LN)水平显著低于对照组(P<0.05);治疗后,研究组总胆红素(total bilirubin,TBil)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天冬氨酸氨基转移酶(aspartate aminotransferase,AST)、碱性磷酸酶(alkaline phosphatasealkaline phosphatase,ALP)和谷氨酸转肽酶(glutamate transpeptidase,GGT)水平均显著低于对照组(P<0.05);研究组不良反应发生率(2.00%)与对照组(1.00%)比较差异无统计学意义。结论前列地尔联合骨化三醇能有效降低Th17/Treg细胞水平,促使其趋向平衡,且联合用药可有效抑制免疫功能亢进,抑制肝损伤,提升治疗效果。
Objective To investigate the effect of alprostadil combined with calcitriol on the improvement of T helper cell 17/T regulatory cell(Th17/Treg)imbalance of primary biliary cirrhosis(PBC).Methods 200 cases of PBC patients were prospectively enrolled and divided into control group and research group by using random number table method.The control group took alprostadil intervention treatment,while the research group adopted alprostadil combined with calcitriol intervention treatment.The clinical efficacy,T cell subsets and cytokine-related indicators,Th17/Treg-related indicators,liver fibrosis indicators,liver function indicators,and adverse reactions were analyzed and compared.Results The effective rate of research group(96.0%)was significantly higher than that of control group(73.0%)(χ^(2)=20.1947,P<0.05).After treatment,the surface antigen differentiation cluster 4 receptor(CD4+),CD4+/surface antigen differentiation cluster 8 receptor(CD4+/CD8+),interleukin-2(IL-2),tumor necrosis factor-α(TNF-α)and interleukin-17(IL-17)in the research group were significantly decreased(P<0.05),and the level of CD8+was significantly higher than that in the control group(P<0.05).After treatment,the levels of Th17 cells,Treg cells and Th17/Treg indexes in the research group were significantly lower than those in the control group(P<0.05).After treatment,the hyaluronidase(HA),procollagen typeⅢ(PCⅢ),collagen typeⅣ(Ⅳ-C)and laminin(LN)in the research group were significantly lower than those in the control group(P<0.05).After treatment,the levels of total bilirubin(TBil),alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP)and glutamate transpeptidase(GGT)in the research group were significantly lower than those in the control group(P<0.05).The incidence of adverse reactions showed no significant difference between the research group(2.00%)and the control group(1.00%)(P>0.05).Conclusion Alprostadil combined with calcitriol therapy can effectively reduce the level of Th17/Treg cells and promo
作者
王文珊
陈颖
何静
王英运
WANG Wenshan;CHEN Ying;HE Jing;WANG Yingyun(Department of Gastroenterology,Wanning People’s Hospital,Wanning 571500,China;Department of Hepatology,Wanning People’s Hospital,Wanning 571500,China;Department of Renal Blood Purification,Wanning People’s Hospital,Wanning 571500,China)
出处
《西北药学杂志》
CAS
2023年第4期153-158,共6页
Northwest Pharmaceutical Journal
基金
海南省卫生计生行业科研项目(编号:16A200034)。
关键词
前列地尔
骨化三醇
辅助性T细胞/调节性T细胞
肝硬化
疗效
alprostadil
calcitriol
T helper cell 17/T regulatory cell(Th17/Treg)
liver cirrhosis
curative effect
