急性肝衰竭患儿细胞免疫及肠黏膜屏障功能临床研究
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摘要
目的探讨急性肝衰竭患儿细胞免疫及肠黏膜屏障的功能变化。方法急性肝衰竭患儿30例为肝衰竭组,体检健康儿童30例为对照组,检测2组细胞免疫、调节性T细胞、血浆内毒素、二胺氧化酶水平变化。结果肝衰竭组患儿CD4~+细胞比率[(21.6±8.7)%]、CD4~+/CD8~+比值(1.33±0.42)、CD4~+CD25~+FOXP3~+调节性T细胞比率[(4.22±1.33)%]较对照组[(59.7±9.2)%、3.75±0.53、(8.35±2.89)%]明显减少(P<0.01),CD8~+细胞比率[(29.8±5.4)%]、血浆内毒素[(21.71±4.47)EU/mL]、二胺氧化酶[(18.91±4.03)u/L]水平较对照组[(23.1±4.4)%、(3.10±1.73)EU/mL、(3.59±1.99)u/L]明显增高(P<0.05)。结论急性肝衰竭患儿存在细胞免疫紊乱,参与肝衰竭的发生、发展,并加重肠道黏膜屏障功能受损。
Objective To explore the changes of cellular immunity and intestinal mucosal barrier function in children with acute liver failure.Methods The levels of cellular immunity,regulatory T cells,plasma endotoxin and diamine oxidase were detected in 30 children with acute liver failure(liver failure group)and 30 healthy controls(control group).Results The percentage of CD4~+cell((21.6±8.7)%),CD4~+/CD8~+ratio(1.33±0.42)and the percentage of CD4~+CD25~+Foxp3~+regulatory T cells((4.22±1.33)%)in liver failure group were significantly lower than those in control group((59.7±9.2)%,3.75±0.53,(8.35±2.89)%)(P<0.01),and the percentage of CD8~+((29.8±5.4)%),the levels of plasma endotoxin((21.71±4.47)EU/mL)and diamine oxidase((18.91±4.03)u/L)were significantly higher than those in control group((23.1±4.43)%,(3.10±1.73)EU/mL,(3.59±1.99)u/L)(P<0.05).Conclusion Cellular immune disorder in children with acute liver failure participates in the occurrence and development of liver failure,and aggravates the intestinal mucosal barrier dysfunction.
Objective To explore the changes of cellular immunity and intestinal mucosal barrier function in children with acute liver failure.Methods The levels of cellular immunity,regulatory T cells,plasma endotoxin and diamine oxidase were detected in 30 children with acute liver failure(liver failure group)and 30 healthy controls(control group).Results The percentage of CD4~+cell((21.6±8.7)%),CD4~+/CD8~+ratio(1.33±0.42)and the percentage of CD4~+CD25~+Foxp3~+regulatory T cells((4.22±1.33)%)in liver failure group were significantly lower than those in control group((59.7±9.2)%,3.75±0.53,(8.35±2.89)%)(P<0.01),and the percentage of CD8~+((29.8±5.4)%),the levels of plasma endotoxin((21.71±4.47)EU/mL)and diamine oxidase((18.91±4.03)u/L)were significantly higher than those in control group((23.1±4.43)%,(3.10±1.73)EU/mL,(3.59±1.99)u/L)(P<0.05).Conclusion Cellular immune disorder in children with acute liver failure participates in the occurrence and development of liver failure,and aggravates the intestinal mucosal barrier dysfunction.
引文
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[7]褚小刚,陈辉,王鲁文,等.急性肝衰竭患者外周血调节性T细胞比率及活性变化[J].中华实验外科杂志,2013,30(1):147-149.
[8]WANG L W,CHEN H,GONG Z J.High mobility group box-1protein inhibits regulatory T cell immune activity in liver failure in patients with chronic hepatitis B[J].Hepatobiliary Pancreat Dis Int,2010,9(5):499-507.
[9]孙海青,娄金丽,刘新,等.急性肝衰竭时外周血和肝组织中调节性T细胞表达变化的初探[J].首都医科大学学报,2014,35(4):447-451.
[10]邹美银,汪美华,顾丽华,等.CD4+及CD8+T淋巴细胞预测人类免疫缺陷病毒感染患者抗反转录病毒治疗效果的价值[J].中华实用诊断与治疗杂志,2017,31(7):690-693.
[2]DEVICTOR D,TISSIERES P,AFANETTI M,et al.Acute liver failure in children[J].Clin Res Hepato Gastmeuter,2011,35(6/7):430-437.
[3]严展鹏,蔡雪停,杨杰,等.调节性T细胞与消化系统疾病关系的研究[J].中国免疫学杂志,2013,29(7):774-778.
[4]杨瑞华,李芹,林恢,等.HBV相关慢加急性肝衰竭患者外周血T细胞亚群,NK细胞的变化及其与预后的关系[J].中国中西医结合消化杂志,2014,22(10):595-597.
[5]SAKAGUCHI S T.Regulatory T cells and immune tolerance[J].Cell,2008,133(5):775-787.
[6]杨阳,韩岩,杨麦贵,等.调节性CD4+CD25+T细胞的分离纯化及疫功能研究[J].中华实验外科杂志,2009,26(12):1620-1622.
[7]褚小刚,陈辉,王鲁文,等.急性肝衰竭患者外周血调节性T细胞比率及活性变化[J].中华实验外科杂志,2013,30(1):147-149.
[8]WANG L W,CHEN H,GONG Z J.High mobility group box-1protein inhibits regulatory T cell immune activity in liver failure in patients with chronic hepatitis B[J].Hepatobiliary Pancreat Dis Int,2010,9(5):499-507.
[9]孙海青,娄金丽,刘新,等.急性肝衰竭时外周血和肝组织中调节性T细胞表达变化的初探[J].首都医科大学学报,2014,35(4):447-451.
[10]邹美银,汪美华,顾丽华,等.CD4+及CD8+T淋巴细胞预测人类免疫缺陷病毒感染患者抗反转录病毒治疗效果的价值[J].中华实用诊断与治疗杂志,2017,31(7):690-693.