慢加急性肝衰竭患者外周血CD8^+ T细胞中CXCR3的表达及意义

CXCR3 expression in peripheral CD8^+ T cells in acute-on-chronic liver failure and clinical relevance

目的探讨慢加急性肝衰竭(ACLF)患者CD8+T细胞上趋化因子受体3(CXCR3)的表达及与转归的关系。方法选择22例ACLF患者、18例普通慢性乙型肝炎(CHB)患者和20例健康志愿者。入院初收集血样,流式细胞仪检测外周血CD8+T细胞上CXCR3的表达。结果 ACLF患者中12例存活。CHB患者CXCR3+CD8+T细胞计数(70.31±38.07)×106·L-1,明显高于健康志愿者的(34.26±22.30)×106·L-1和ACLF患者的(10.63±8.57)×106·L-1,差异有统计学意义(P<0.05)。CXCR3+CD8+T细胞数量与ln ALT、ln AST或总胆红素水平无明显相关性。存活的ACLF患者CXCR3+CD8+T细胞计数(14.40±9.35)×106·L-1,明显高于死亡患者的(6.10±4.78)×106·L-1,差异有统计学意义(P=0.021)。结论 ACLF患者外周血CXCR3+CD8+T细胞的计数下降,并且可能与转归相关。

Objective To investigate the CXC chemokine receptor（CXCR） -3 expression in CD8 ^＋T cells in a- cute - on - chronic liver failure （ACLF） and the association with outcomes. Methods A total of 22 ACLF patients, 18 chronic hepatitis B （CHB） patients, and 20 healthy volunteers were enrolled. Blood samples were collected at the begin- ning of hospitalization for ACLF and CHB patients. CXCR3 expression on peripheral CD8^ ＋ T cells was determined by flow cytometry. Results Twelve ACLF patients survived. CXCR3 ^＋ CD8 ^＋ T cell counts in CHB patients （70. 31 ± 38.07 × 10^6/L） were higher than those in healthy controls （ （34. 26 ± 22. 30） × 10^6/L） （P 〈 0. 05 ）, and the latter were higher than those in ACLF patients （ （10. 63 ± 8.57） × 10^6/L） （P 〈 0. 05）. The CXCR3 ^＋ CD8 ^＋ T cells counts were not associ- ated with ln（ ALT）, In（ AST）, or total serum bilirubin levels. Between survivors and deceased in ACLF patients, there were significant differences in CXCR3 ^＋CD8 ^＋ T cell counts （ （ 14.40 ± 9.35 ） vs （6. 10± 4. 78 ） × 10^6/L ; P = 0. 021 ）. Conclusion The counts of peripheral CXCR3 ^＋ CD8 ^＋ T cells decreased significantly in ACLF, and it might be associated with, poor clinical outcomes.