原发性胆汁性肝硬化合并系统性红斑狼疮患者外周血T细胞分化比例及其临床意义

Differentiation ratio of peripheral blood T cells in patients with primary biliary cirrhosis complicated with systemic lupus erythematosus and its clinical significance

目的探讨原发性胆汁性肝硬化合并系统性红斑狼疮患者外周血T细胞分化比例及其临床意义。方法选取解放军联勤保障部队天津康复疗养中心(原第四六四医院)2018年1月至2021年1月收治的60例原发性胆汁性肝硬化合并系统性红斑狼疮患者作为研究对象,另选取同期来我院体检的健康者作为对照组,对比两组受检者外周血T淋巴细胞亚群表达,相关炎症细胞因子mRNA表达以及血清中Th1类、Th2类、Th17类细胞因子分泌情况。结果病例组CD3^(+)、CD4^(+)、CD16^(+)、CD56^(+)、Treg、CD4^(+)/CD8^(+)分别为(67.84±9.56)%、(34.92±5.83)%、(18.39±1.58)%、(17.26±1.85)%、(3.15±1.23)%、(1.32±0.21)%,对照组为(74.85±8.95)%、(43.18±5.25)%、(21.83±1.24)%、(20.39±2.84)%、(4.82±1.42)%、(1.93±0.24)%,病例组明显低于对照组(P<0.05),病例组CD8^(+)表达水平为(29.75±3.95)%,对照组为(26.82±4.17)%,病例组明显高于观察组(P<0.05);病例组干扰素γ(interferon gamma,IFN-γ)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-2(interleukin-2,IL-2)、白细胞介素-4(interleukin-2,IL-4)、白细胞介素-6(interleukin-6,IL-6)、白细胞介素-10(interleukin-10,IL-10)、白细胞介素-17A(interleukin-17A,IL-17A)、白细胞介素-22(interleukin-22,IL-22)mRNA表达分别为(0.637±0.014)、(0.735±0.133)、(0.952±0.007)、(0.634±0.025)、(0.753±0.038)、(0.722±0.026)、(0.683±0.047)、(0.933±0.019),高于对照组[分别为(0.575±0.023)、(0.641±0.037)、(0.631±0.005)、(0.593±0.036)、(0.522±0.023)、(0.512±0.041)、(0.573±0.045)、(0.566±0.012)],差异具有统计学意义(P<0.05);病例组Th1类(IFN-γ、TNF-α、IL-2)、Th2类(IL-4、IL-6、IL-10)、Th17类(IL-17A、IL-22)细胞因子分泌水平明显高于对照组(P<0.05)。结论原发性胆汁性肝硬化合并系统性红斑狼疮患者外周血T淋巴细胞亚群比例明显降低,提示患者有免疫功能下降,且原发性胆汁性肝硬化合并系统性红斑狼疮患者会合并明显炎症反应升高现象。

Objective To investigate the differentiation ratio of peripheral blood T cells in patients with primary biliary cirrhosis(PBC)complicated with systemic lupus erythematosus(SLE)and its clinical significance.Methods Sixty patients with PBC complicated with SLE treated in our hospital from January 2018 to January 2021 were selected as the case group.In addition,healthy people who came to our hospital for physical examination in the same period were selected as the control group.The expression of T lymphocyte subsets in peripheral blood,mRNA expression of related inflammatory cytokines and secretion of Th1,Th2,Th17 cytokines in serum were compared between the two groups.Results The ratio of CD3^(+),CD4^(+),CD8^(+),CD16^(+),CD56^(+),Treg and CD4^(+)/CD8^(+)in the case group were significantly lower than those in the control group[(67.84±9.56)%VS(74.85±8.95)%,(34.92±5.83)%VS(43.18±5.25)%,(18.39±1.58)%VS(21.83±1.24)%,(17.26±1.85)%VS(20.39±2.84)%,(3.15±1.23)%VS(4.82±1.42)%,(1.32±0.21)%VS(1.93±0.24)%,respectively,all P<0.05],and CD8^(+)was higher than that in the control group[(29.75±3.95)%VS(26.82±4.17)%,P<0.05].The mRNA expressions of interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α),interleukin-2(IL-2),interleukin-4(IL-4),interleukin-6(IL-6),interleukin-10(IL-10),interleukin-17A(IL-17A)and interleukin-22(IL-22)in the control group were higher than those in the control group[(0.637±0.014)VS(0.575±0.023),(0.735±0.133)VS(0.641±0.037),(0.952±0.007)VS(0.631±0.005),(0.634±0.025)VS(0.593±0.036),(0.753±0.038)VS(0.522±0.023),(0.722±0.026)VS(0.512±0.041),(0.683±0.047)VS(0.573±0.045),(0.933±0.019)VS(0.566±0.012),respectively],the difference was statistically significant(all P<0.05).The secretion levels of Th1(IFN-γ,TNF-α,IL-2),Th2(IL-4,IL-6,IL-10)and Th17(IL-17A,IL-22)cytokines in the case group were significantly higher than those in the control group(P<0.05).Conclusion There are significant differences in peripheral blood T cell subsets between patients with PBC complicated with SLE and healthy subjects.There are different degrees of abnormal cellular immune regulation and immune dysfunction.