慢性乙肝患者外周血PBMC凋亡相关因子和Th1/Th2型细胞因子的水平变化及意义
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摘要
目的探讨慢性乙型肝炎患者外周血单个核细胞(PBMC)凋亡相关因子和Th1/Th2型细胞因子水平变化及意义。方法前瞻性选取2017年1月至2017年12月在航空工业三六三医院治疗的慢性乙型肝炎患者102例,其中轻度32例,中度40例,重度30例,健康志愿者40例作为对照组。检测含半胱氨酸的天冬氨酸蛋白水解酶-9(Caspase-9)、Caspase-8、Caspase-3、白细胞介素-2(IL-2)、IL-4、IL-10和干扰素-γ(IFN-γ)水平。记录慢性乙型肝炎患者HBV DNA定量检测结果,分析HBV DNA与各指标相关性。结果轻度组、中度组和重度组Caspase-9、Caspase-8和Caspase-3水平明显高于对照组(P <0. 05),其中轻度组Caspase-9、Caspase-8和Caspase-3明显高于中度组和重度组(P <0. 05);轻度组、中度组和重度组IL-2和IFN-γ水平明显低于对照组(P <0. 05),而IL-4和IL-10明显高于对照组(P <0. 05),其中轻度组IL-2和IFN-γ也明显高于中度组和重度组(P <0. 05),而IL-4和IL-10则明显低于中度组和重度组(P <0. 05);病毒载量与Caspase-9、Caspase-8、Caspase-3、IL-2和IFN-γ呈正相关(r=0. 370,r=0. 364,r=0. 355,r=0. 341和r=0. 360,P <0. 05),与IL-4、IL-10呈负相关(r=-0. 411,r=-0. 403,P <0. 05)。结论慢性乙肝患者外周血PBMC凋亡增强,Th1/Th2免疫调节紊乱,可能在疾病发生发展中起一定作用,且与病毒载量有一定相关性。
Objective To investigate the level and significance of peripheral blood mononuclear cells( PBMC) apoptosis related factors and Th1/Th2 type cytokines in patients with chronic hepatitis B. Methods A prospective study was conducted,102 cases of chronic hepatitis B treated in our hospital from January 2017 to December 2017 were selected,including 32 mild patients,40 moderate patients,30 severe patients,and 40 healthy volunteers as control group,the cysteine containing aspartate protein hydrolase-9( Caspase-9),Caspase-8,Caspase-3,interleukin-2( IL-2),IL-4,IL-10 and interferon( IFN-γ) were detected. Results The Caspase-9,Caspase-8 and Caspase-3 in mild group,moderate group and severe group were significantly higher than those in the control group( P < 0. 05),the Caspase-9,Caspase-8 and Caspase-3 in mild group were significantly higher than those in moderate group and severe group( P < 0. 05); The IL-2 and IFN-γ in mild group,moderate group and severe group were significantly lower than those in the control group( P < 0. 05),while IL-4 and IL-10 were significantly higher than those in control group( P < 0. 05),the IL-2 and IFN-γ in mild group were significantly higher than those in moderate group and severe group( P < 0. 05),while IL-4 and IL-10 were significantly lower than those in moderate group and severe group( P < 0. 05);The viral load was positively correlated with Caspase-9,Caspase-8,Caspase-3,IL-2 and IFN-( r = 0. 370,r = 0. 364,r = 0. 355,r =0. 341 and r = 0. 360,P < 0. 05),was negative correlated with IL-4 and IL-10( r =-0. 411,r =-0. 403,P < 0. 05). Conclusion The apoptosis of PBMC in peripheral blood of patients with chronic hepatitis B are increased,and the immune regulation of Th1/Th2 is disturbed,which may play a role in the development of disease,and has a certain correlation with the viral load.
Objective To investigate the level and significance of peripheral blood mononuclear cells( PBMC) apoptosis related factors and Th1/Th2 type cytokines in patients with chronic hepatitis B. Methods A prospective study was conducted,102 cases of chronic hepatitis B treated in our hospital from January 2017 to December 2017 were selected,including 32 mild patients,40 moderate patients,30 severe patients,and 40 healthy volunteers as control group,the cysteine containing aspartate protein hydrolase-9( Caspase-9),Caspase-8,Caspase-3,interleukin-2( IL-2),IL-4,IL-10 and interferon( IFN-γ) were detected. Results The Caspase-9,Caspase-8 and Caspase-3 in mild group,moderate group and severe group were significantly higher than those in the control group( P < 0. 05),the Caspase-9,Caspase-8 and Caspase-3 in mild group were significantly higher than those in moderate group and severe group( P < 0. 05); The IL-2 and IFN-γ in mild group,moderate group and severe group were significantly lower than those in the control group( P < 0. 05),while IL-4 and IL-10 were significantly higher than those in control group( P < 0. 05),the IL-2 and IFN-γ in mild group were significantly higher than those in moderate group and severe group( P < 0. 05),while IL-4 and IL-10 were significantly lower than those in moderate group and severe group( P < 0. 05);The viral load was positively correlated with Caspase-9,Caspase-8,Caspase-3,IL-2 and IFN-( r = 0. 370,r = 0. 364,r = 0. 355,r =0. 341 and r = 0. 360,P < 0. 05),was negative correlated with IL-4 and IL-10( r =-0. 411,r =-0. 403,P < 0. 05). Conclusion The apoptosis of PBMC in peripheral blood of patients with chronic hepatitis B are increased,and the immune regulation of Th1/Th2 is disturbed,which may play a role in the development of disease,and has a certain correlation with the viral load.
引文
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[3]梅昭荷,聂红明,汪蓉,等.从Th1/Th2、Treg/Th17之间的平衡研究轻、中度慢性乙型肝炎患者CD4+T淋巴细胞的免疫失衡状态[J].肝脏,2017,22(6):513-516.
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[8] Minami T,Tateishi R,Shiina S,et al. Comparison of improved prognosis between hepatitis B and hepatitis C-related hepatocellular carcinoma[J]. Hepatol Res,2015,45(10):E99-E107.
[9]张琨,张孝国,崔杏杏,等.慢性HBV感染者外周血单个核细胞凋亡相关因子的表达及其与乙肝慢性化的关系[J].山东大学学报(医学版),2016,54(7):38-42.
[10]侯建明,吴贺文. HBeAg阳性慢性乙型肝炎患者肝功能损伤程度与Th1/Th2细胞因子水平的相关性研究[J].肝脏,2017,22(5):429-431.
[11]郭永红,周云,张颖,等.慢加急性乙型肝炎肝衰竭患者Th1/Th2细胞的细胞因子变化及与肝功能指标的关系[J].检验医学,2014,29(3):274-278.
[12]顾静,王艳,陈丽,等. HBV相关慢加急性肝衰竭患者血清IL-32和IL-10水平变化及意义[J].临床肝胆病杂志,2018,34(4):801-805.
[13]刘宁,徐杰,刘金花,等.慢性乙型肝炎、乙肝肝硬化、乙肝肝癌患者Th1/Th2型细胞因子水平变化研究[J].胃肠病学和肝病学杂志,2014,23(2):158-161.
[14]刘佳.慢性乙型肝炎病毒感染对外周血单个核细胞中凋亡分子表达的影响及其与免疫功能的相关性[J].安徽医药,2017,21(10):1830-1833.
[2]邵丽春,邓国伟,金国贤.慢性乙型肝炎外周血单个核细胞与血清中TOⅡ样受体及Th1/Th2/Th17型细胞因子的表达[J].中国临床医生杂志,2016,44(11):39-42.
[3]梅昭荷,聂红明,汪蓉,等.从Th1/Th2、Treg/Th17之间的平衡研究轻、中度慢性乙型肝炎患者CD4+T淋巴细胞的免疫失衡状态[J].肝脏,2017,22(6):513-516.
[4]黄飞.乙肝患者外周血单个核细胞中凋亡分子表达量与肝功能、炎症反应程度的关系[J].海南医学院学报,2017,23(5):642-644.
[5] Zhang J,Fan Y,Zhao Z,et al. Prognoses of patients with acute-onchronic hepatitis B liver failure are closely associated with altered SOCS1mRNA expression and cytokine production following glucocorticoid treatment[J]. Cell Mol Immunol,2014,11(4):396-404.
[6] Liu R,Shen S,Hu X,et al. Prognosis of the intrahepatic cholangiocarcinoma after resection:hepatitis B virus infection and adjuvant chemotherapy are favorable prognosis factors[J]. Cancer Cell Inter,2013,13(1):99-101.
[7] Wu F,Shi K,Chen Y,et al. Scoring systems predict the prognosis of acute-on-chronic hepatitis B liver failure:an evidence-based review[J]. Expert Rev Gastroenterol Hepatol,2014,8(6):623-632.
[8] Minami T,Tateishi R,Shiina S,et al. Comparison of improved prognosis between hepatitis B and hepatitis C-related hepatocellular carcinoma[J]. Hepatol Res,2015,45(10):E99-E107.
[9]张琨,张孝国,崔杏杏,等.慢性HBV感染者外周血单个核细胞凋亡相关因子的表达及其与乙肝慢性化的关系[J].山东大学学报(医学版),2016,54(7):38-42.
[10]侯建明,吴贺文. HBeAg阳性慢性乙型肝炎患者肝功能损伤程度与Th1/Th2细胞因子水平的相关性研究[J].肝脏,2017,22(5):429-431.
[11]郭永红,周云,张颖,等.慢加急性乙型肝炎肝衰竭患者Th1/Th2细胞的细胞因子变化及与肝功能指标的关系[J].检验医学,2014,29(3):274-278.
[12]顾静,王艳,陈丽,等. HBV相关慢加急性肝衰竭患者血清IL-32和IL-10水平变化及意义[J].临床肝胆病杂志,2018,34(4):801-805.
[13]刘宁,徐杰,刘金花,等.慢性乙型肝炎、乙肝肝硬化、乙肝肝癌患者Th1/Th2型细胞因子水平变化研究[J].胃肠病学和肝病学杂志,2014,23(2):158-161.
[14]刘佳.慢性乙型肝炎病毒感染对外周血单个核细胞中凋亡分子表达的影响及其与免疫功能的相关性[J].安徽医药,2017,21(10):1830-1833.