外周血单核细胞在肝硬化伴感染时的活化研究

Activation of peripheral blood mononuclear cells in cirrhosis patients with infection

目的了解感染因素对肝硬化患者肝损伤的影响,并探讨外周血单核细胞的相关活性分子的检测对肝硬化患者中并发感染的诊断及预测价值。方法选择肝硬化患者共39例,其中肝硬化感染组16例,肝硬化非感染组23例;另外纳入普通感染组24例,健康对照组32例。统计分析各组的相关临床指征及检验结果,检测肝硬化患者外周血单核细胞的相关活性分子的表达,比较肝硬化感染组与肝硬化非感染组的表达差异是否有统计学意义。结果普通感染组患者相对于健康对照组未出现肝损伤指标上升,而肝硬化感染组相较于肝硬化非感染组,外周血单核细胞的相关活性分子的mRNA表达上升显著,且肝损伤的程度也更为严重。结论并发感染的肝硬化患者相对非感染患者肝损伤程度加重,单核细胞的相关活性分子表达水平与感染状态密切相关,提示了并发感染后肝硬化加重的潜在机制,且在肝硬化患者并发感染的筛查及诊断中具潜在应用价值。

Objective To investigate the effect of infectious factors on liver injury in patients with liver cirrhosis,and to investigate the diagnostic and predictive values of the detection of relevant active molecules in peripheral blood mononuclear cells in patients with cirrhosis.Methods A total of 39 patients with cirrhosis admitted to our hospital in 2018 were enrolled,including 16 patients with cirrhosis and infection and 23 patients with cirrhosis and no infection.In addition,24 patients without cirrhosis but with infection were included in the general infection control group and 32 healthy controls were included in the healthy control group.The clinical indications and test results of each group were statistically analyzed.The expression of related active molecules in peripheral blood mononuclear cells was assessed.The difference in expression between the infected group and the non-infected group was compared.Results There was no increase in liver injury index in the general infection group compared with the healthy control group;but the mRNA expression of the relevant active molecules in the peripheral blood mononuclear cells were significantly increased in the cirrhotic infection group compared with the cirrhotic non-infected group.Conclusion The degree of liver injury in patients with cirrhosis complicated by infection is more serious than non-infected patients.The expression levels of related active molecules in monocytes is closely correlated to the infection status,suggesting the potential mechanism of cirrhosis after concurrent infection,and concurrent infection in patients with cirrhosis.