慢性肝病患者的免疫功能指标与病理学改变关系的初步研究

Relationship between Immunological Markers and Hepatic Pathological Findings in Chronic Liver Diseases

目的：研究免疫功能指标与肝组织炎症和纤维化程度的关系。方法：对２００例慢性乙型肝炎患者行肝组织活检，并分析其免疫功能指标与肝组织炎症和肝纤维化程度、肝功能指标与血清纤维化指标的关系。结果：外周血Ｔ淋巴细胞亚群、白细胞介素（ＩＬ）２和ＩｇＭ水平在不同肝组织学炎症和纤维化程度患者间无显著差异（Ｐ＞００５），血清干扰素（ＩＦＮ）γ水平与肝组织炎症无明显相关（Ｐ＞０．０５），Ｓ０期显著低于其他各期（Ｐ＜０．０５），但Ｓ１～Ｓ４期间无显著差异（Ｐ＞０．０５）。外周血ＮＫ细胞活性随肝组织炎症程度的加重逐渐降低（Ｐ＜０．０５），随肝纤维化程度的加重有逐渐降低的趋势，但无显著差异（Ｐ＞０．０５）。ＩｇＡ水平随肝组织炎症程度的加重逐渐升高，在肝纤维化程度各分期间尽管有差异，但无显著性（Ｐ＞０．０５）。ＩｇＧ水平随肝组织炎症程度和纤维化程度加重有升高趋势，分别在Ｇ４（Ｐ＜０．０１）和Ｓ４（＜０．０５）期最高。相关分析表明ＮＫ细胞、ＩｇＡ和ＩｇＧ与肝功能指标和血清纤维化指标有一定相关性（Ｐ＜０．０５），其他免疫功能指标与肝功能和血清纤维化指标无显著相关（Ｐ＞０．０５）。结论：外周血ＮＫ细胞活性、ＩｇＡ和ＩｇＧ水平对辅助诊断肝纤维?

Background/Aims: To study the relationship between immunological markers and hepatic patho- logical findings. Methods: Immunological markers, liver function and serum markers of fibrosis were measured in 200 patients with chronic liver diseases. Results: Peripheral T lymphocyte subsets, serum IL-2, and IgM levels were not significantly correlated with hepatic histological findings (P> 0.05), but there was no relationship between serum IFN-γ level and hepatic histological inflammation. However, peripheral NK cell activity, IgA and IgG were related with hepatic histologic findings, liver function, and serum markers of fibrosis (P< 0.05). Conclusionst Measurement of peripheral blood NK cell ac- tivity, IgA and IgG may help to diagnose liver fibrosis.