自身免疫性肝炎患者肝脏巨噬细胞极化分型研究

The study of liver macrophages polarization in patients with autoimmune hepatitis

初步探讨并揭示自身免疫性肝炎（AIH）肝组织巨噬细胞的功能表型。研究结果发现，AIH患者肝组织CD68＋细胞绝对数显著高于非酒精性脂肪性肝病（NAFLD）、慢性乙型肝炎（CHB）（P均〈0.05），其与ALT及IgG水平均呈正相关，相关系数分别为0.600、0.700（P＝0.285，P＝0.188）；AIH、CHB患者肝组织的诱导型一氧化氮合酶（iNOS）阳性细胞绝对数以及TNFα、iNOS、IL－1β相对表达量均显著高于NAFLD患者（P均〈0.05）；NAFLD患者肝组织CD206＋细胞绝对数显著高于AIH、CHB患者（P均〈0.05），CD206相对表达量高于AIH、CHB患者，但差异无统计学意义。AIH患者炎症反应及肝损伤过程中巨噬细胞活化且似以M1促炎表型为主。

To explore the functional phenotype of liver macrophages in patients with autoimmune hepatitis （AIH）. Compared with patients with nonalcoholic fatty liver disease （NAFLD） and chronic hepatitis B （CHB）, the absolute CD68＋ cell count in patients with AIH was significantly higher （all P〈0.05）. It was positively correlated with ALT and IgG levels （the correlation coefficients 0.600 and 0.700, P=0.285 and 0.188 respectively）. Additionally, compared with patients with NAFLD, the absolute iNOS positive cell count in patients with AIH and CHB were significantly higher （all P〈0.05）. The expression of TNFα, iNOS and IL-1β in patients with AIH and CHB were significantly higher than in patients with NAFLD （all P〈0.05）. Interestingly, compared with patients with AIH and CHB, the absolute CD206＋ cell count in patients with NAFLD were significantly higher （all P〈0.05）. CD206 expression in patients with NAFLD was higher than patients with AIH and CHB, but with no statistical significance. M1 type macrophages over-expressed and played a major role in the inflammatory reaction and liver injury in patients with AIH.