ACHBLF患者外周血中NK与NKT细胞的变化及与肝功能和细胞因子的关系

The changes of NK and NKT cells in peripheral blood of patients with ACHBLF and its correlation with liver function and cytokines

目的研究慢加急性乙型肝炎肝功能衰竭(acute-on-chronic hepatitis B liver failure,ACHBLF)患者外周血中自然杀伤细胞(natural killer cells,NK)与自然杀伤T细胞(natural killer T cells,NKT)细胞的变化及其与肝功能及细胞因子的关系。方法选择2015年6月至2018年8月诊断为ACHBLF的45例患者作为ACHBLF组、诊断为慢性乙肝(CHB)的58例患者作为CHB组,另取同期体检中心体检的50例健康志愿者作为研究的对照组。采集外周血并测定NK细胞、NKT细胞的含量,采集血清并测定肝功能指标、炎症细胞因子的含量。结果ACHBLF组和CHB组患者外周血中NK细胞及NKT细胞的含量均显著低于对照组,血清中丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(γ-GT)、总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-32(IL-32)、CC亚族趋化因子配体20(CCL20)、高迁移率族蛋白B1(HMGB1)的含量均显著高于对照组(P<0.05);ACHBLF组患者外周血中NK细胞及NKT细胞的含量均显著低于CHB组,血清中ALT、AST、γ-GT、TBIL、DBIL、IBIL、TNF-α、IFN-γ、IL-6、IL-8、IL-32、CCL20、HMGB1的含量均显著高于CHB组(P<0.05);ACHBLF组患者外周血中NK细胞、NKT细胞含量与血清中ALT、AST、γ-GT、TBIL、DBIL、IBIL、TNF-α、IFN-γ、IL-6、IL-8、IL-32、CCL20、HMGB1的含量呈负相关(P<0.05)。结论ACHBLF患者外周血中NK与NKT细胞含量的减少与肝功能恶化、炎性反应激活密切相关。

Objective To investigate the changes of NK and NKT cells in peripheral blood of patients with acute-on-chronic hepatitis B liver failure(ACHBLF)and its correlation with liver function and cytokines.Methods A total of 45 patients with ACHBLF were enrolled as ACHBLF group,and 58 patients with chronic hepatitis B(CHB)were enrolled as CHB group,moreover,50 healthy volunteers who underwent health examination in our hospital from June 2015 to August 2018 were enrolled as control group.The levels of NK and NKT cells in peripheral blood of patients and liver function indexes as well as inflammatory cytokines levels were observed and compared among the three grousp.Results The levels of NK cells and NKT cells in ACHBLF group and CHB group were significantly lower than those in control group,however,the serum levels of ALT,AST,γ-GT,TBIL,DBIL,IBIL,TNF-α,IFN-γ,IL-6,IL-8,IL-32,CCL20 and HMGB1 were significantly higher than those in control group(P<0.05).Moreover the levels of NK cells and NKT cells in ACHBLF group were significantly lower than those in CHB group,whereas the serum levels of ALT,AST,γ-GT,TBIL,DBIL,IBIL,TNF-α,IFN-γ,IL-6,IL-8,IL-32,CCL20 and HMGB1 were significantly higher than those in CHB group(P<0.05).In addition of the levels of NK cells and NKT cells in ACHBLF group were negatively correlated with those of ALT,AST,γ-GT,TBIL,DBIL,IBIL,TNF-α,IFN-γ,IL-6,IL-8,IL-32,CCL20 and HMGB1(P<0.05).Conclusion The decrease of NK and NKT cell contents in peripheral blood of patients with ACHBLF is closely related to liver function deterioration and inflammatory response activation.