自身免疫性肝病重叠综合征患者外周血中调节性T淋巴细胞水平研究

The level of regulatory T lymphocytes in peripheral blood of patients with autoimmune hepatitis and primary biliary cholangitis overlap syndrome

目的:观察自身免疫性肝炎-原发性胆汁性胆管炎重叠综合征(AIH-PBC OS)患者外周血中调节性T淋巴细胞分布特点。方法:回顾性分析2013年1月~2018年1月我科就诊的AIH-PBC OS患者23例,自身免疫性肝炎(AIH)94例,予肝功能、凝血项、免疫球蛋白G、自身免疫抗体和调节性T淋巴细胞(Tregs细胞)水平检测,同时选取健康人20例,予调节性T淋巴细胞检测。结果:OS组患者γ-谷氨酰转肽酶、碱性磷酸酶和免疫球蛋白G水平(分别为166.7±135.6U/L、261.1±201.7 U/L和24.1±10.7g/L)显著高于AIH组(104.1±83.8U/L,149.2±125.6U/L和18.7±6.4g/L)(均P<0.05);OS组、AIH组患者Treg细胞/辅助性T细胞比值(5.7±2.5%vs.5.7±2.4%)无显著性差异(P>0.05),但低于健康对照组(7.4±1.4%)。结论 :AIH-PBC OS与AIH患者均有Tregs细胞比例的下降,可能是AIH-PBC OS免疫发病机制之一。

Objective:To observe the distribution of regulatory T lymphocytes in peripheral blood of patients with autoimmune hepatitis and primary biliary cholangitis overlap syndrome.Methods:From January 2013 to January 2018,23 cases of autoimmune hepatitis with primary biliary cholangitis overlap syndrome and 94 cases of autoimmune hepatitis were retrospectively analyzed.Another 20 healthy individuals were enrolled as health control.The liver function,coagulation items,immunoglobulin G,autoimmune antibodies and regulatory T lymphocytes(Tregs cells)were detected.Results:The levels ofγ-glutamyl transpeptidase,alkaline phosphatase and immunoglobulin G of patients with overlap syndrome(166.7±135.6 U/L,261.1±201.7 U/L and 24.1±10.7 g/L,respectively)were higher than those with autoimmune hepatitis(104.1±83.8 U/L149.2±125.6 U/L and 18.7±6.4 g/L)(P<0.05).The ratios of Treg cells to helper T cells in patients with overlap syndrome and autoimmune hepatitis were 5.7±2.5%and 5.7±2.4%.There was no significant difference between the two groups(P>0.05),but they were lower than that in the healthy control group(7.4±1.4%).Conclusion:The proportions of Tregs cells in patients with autoimmune hepatitis-primary biliary cholangitis overlap syndrome and autoimmune hepatitis are decreased.It may be one of the immune pathogenesis of autoimmune hepatitis-primary biliary cholangitis overlap syndrome.