外周血Th细胞水平在肝炎肝硬化肝癌中的检测价值

Detection Value of Th Cell Level in Peripheral Blood in Hepatitis Cirrhosis and Hepatocellular Carcinoma

目的:探讨外周血Th细胞水平在肝炎、肝硬化、肝癌中的检测价值。方法:选取我科室2017年3月至2018年3月收治的91例肝病患者为研究对象,其中34例为慢性乙型肝炎患者,31例为肝硬化患者,26例为肝癌患者。同时选取肝功能正常的30例健康体检者为对照组。采用酶联免疫吸附(ELISA)法测定以上患者及对照组的外周血Th细胞因子—Th1类因子[干扰素(IFN)-γ、白细胞介素(IL)-12、肿瘤坏死因子(TNF)-α]、Th2类因子[IL-4)、IL-6、IL-10],并采用流式细胞仪测定Th细胞亚群(CD3+、CD4+、CD8+)的情况。结果:乙肝组的IL-2、IFN-γ、TNF-α、IL-4、IL-10均高于肝硬化组,IL-6低于肝硬化组,差异有统计学意义(P<0.05)。乙肝组的IL-12、IL-6、IL-10高于肝癌组,IFN-γ、TNF-α低于肝癌组,差异有统计学意义(P<0.05)。肝硬化组的IFN-γ、TNF-α、IL-4、IL-10低于肝癌组,IL-6高于肝癌组,差异有统计学意义(P<0.05)。乙肝组以及肝硬化组的IL-12、IFN-γ、TNF-α、IL-4、IL-6、IL-10均低于对照组,差异均有统计学意义(P <0.05)。肝癌组的IL-12、IFN-γ、IL-4、IL-6、IL-10均低于对照组,差异有统计学意义(P <0.05)。乙肝组、肝硬化组、肝癌组的CD3+、CD4+、CD8+、CD4+/CD8+之间的差异也存在统计学意义(P <0.05)。结论:肝炎、肝硬化、肝癌患者的Th1、Th2类细胞因子表达呈现异常状态,Th1/Th2平衡破坏,对HBV病毒的清除作用受到抑制,应重视对患者Th1/Th2类细胞因子的检测。

Objective: To explore the detection value of peripheral blood Th cells in hepatitis,cirrhosis and liver cancer. Methods: 91 patients with liver diseases admitted by our department from March 2017 to March 2018 were selected as subjects,among which 34 were patients with chronic hepatitis b,31 were patients with liver cirrhosis and 26 were patients with liver cancer. Meanwhile,30 healthy subjects with normal liver function were selected as the control group. Using enzyme-linked immunosorbent (ELISA) method above and the control group in the peripheral blood of patients with Th cytokines-Th1 class factor [interferon (IFN)-gamma,interleukin (IL)-12,tumor necrosis factor (TNF)-alpha],Th2 factor [IL-4),IL-6,IL-10],the cells and the determination of Th cells (CD3 +,CD4 +,CD8 +). Results: IL-2,IFNgamma,TNF-a,IL-4 and IL-10 in hepatitis B group were higher than those in cirrhosis group,while IL-6 was lower than that in cirrhosis group (P < 0.05). The levels of IL-12,IL-6 and IL-10 in the hepatitis b group were higher than those in the liver cancer group,while the levels of ifn-fractionation and TNF-were significantly lower than those in the liver cancer group (P <0.05). The levels of ifn-beta,TNF-,IL-4 and IL-10 in the liver cirrhosis group were lower than those in the liver cancer group and IL-6 was higher than those in the liver cancer group,with statistically significant differences (P <0.05). IL-12,ifn-beta,TNF-,IL-4,IL-6,and IL-10 in the hepatitis b group and the cirrhosis group were lower than those in the control group,with statistically significant differences (P <0.05). IL-12,ifn-fractionation,IL-4,IL-6,and IL-10 in the liver cancer group were all lower than those in the control group,with statistically significant differences (P <0.05). There were also statistically significant differences in CD3+,CD4+,CD8+ and CD4+/CD8+ between the hepatitis B group,the liver cirrhosis group and the liver cancer group (P <0.05). Conclusion: The expression of Th1 and Th2 cytokines is abnormal in patients with hepatitis,cirrhosis and hepatocellular carcinoma. The balance of Th1/Th2 is destroyed and the clearance of HBV virus is inhibited. The detection of Th1/Th2 cytokines in patients with hepatitis,cirrhosis and hepatocellular carcinoma should be emphasized.