不同阶段原发性胆汁性胆管炎患者外周血T淋巴细胞亚群变化

Changes of T lymphocyte subsets in peripheral blood of patients with primary biliary cholangitis at different stages

目的了解原发性胆汁性胆管炎(PBC)患者疾病过程中外周血单个核细胞中CD4^+T细胞及调节性T细胞(Treg)改变。方法采用流式细胞术分析36例PBC患者(PBC组)及15例健康对照者(健康对照组)外周血单个核细胞中CD4^+T细胞及CD4^+CD25^+FoxP3^+Treg水平及不同疗效及临床分期PBC患者治疗前后Treg水平变化。结果PBC组外周血中CD4^+CD25^+FoxP3^+Treg水平[(3.61±1.82)%]比健康对照组[(9.80±4.70)%]水平显著降低,差异有统计学意义(P<0.05)。分析PBC患者治疗前Treg水平及实验室指标相关性,可见PBC患者Treg水平与碱性磷酸酶(r=0.257,P=0.03)、IgM(r=0.241,P=0.045)等生化指标呈正相关;CD4^+T细胞与年龄呈负相关(r=-0.252,P=0.033)。Treg水平在不同疗效PBC患者组内及组间比较差异均无统计学意义(P>0.05),不同阶段的PBC患者比较仅在第2阶段可见显著升高,差异有统计学意义(P=0.033)。结论PBC患者疾病早期体内Treg水平显著高于其他分期,熊去氧胆酸治疗不影响患者体内Treg水平。

Objective To understand the change of CD4^+T cells and Treg in peripheral blood mononuclear cells of patients with PBC.Methods Flow cytometry was used to analyze the levels of CD4^+T cells and CD4^+CD25^+FoxP3^+Treg in peripheral blood mononuclear cells of 36 patients with PBC(PBC group)and 15 healthy controls(healthy control group),as well as the changes of Treg levels in patients with PBC before and after treatment in different therapeutic effects and clinical stages.Results The percentage of CD4^+CD25^+FoxP3^+Treg of PBC group[(3.61±1.82)%]was significantly lower than healthy control group[(9.80±4.70)%],the difference was statistically significant(P<0.05).Analysis the correlation of Treg levels and laboratory indicators before treatment,ALP(r=0.257,P=0.03),IgM(r=0.241,P=0.045)were positively relationship with Treg levels,age of patients(r=-0.252,P=0.033)was negatively correlated with CD4^+T cells.Treg level in PBC patients with different curative effects showed no statistical significance(P>0.05),while the level of Treg in PBC patients with different stages only increased significantly in stage 2,with statistical significance(P=0.033).Conclusion Treg levels in patients with PBC are significantly higher in the early stage of disease than in other stages,and ursodeoxycholic acid treatment do not affect Treg levels in patients.