原发性胆汁性肝硬化患者免疫功能及肝功能损伤情况研究

目的研究原发性胆汁性肝硬化患者的免疫功能改变及肝功能损伤情况。方法选取2013年3月至2016年3月攀枝花市中西医结合医院收治的原发性胆汁性肝硬化患者30例作为观察组,肝功能轻度损伤者17例,肝功能严重损伤者13例;另外选取同期因其他肝脏疾病入院的30例患者作为其他肝病组,选取同期行健康体检的30例作为健康组,采用流式细胞术对3组研究对象的免疫细胞进行检测,比较3组外周血树突状细胞亚群及肝功能指标等。结果观察组患者CD4~+细胞(29.9%)、CD8~+细胞(28.8%)显著高于健康组,且差异有统计学意义(P0.05);而CD11c~+细胞(0.087%)、CD123~+细胞(0.035%)及NK细胞(13.333%)明显低于健康组,且差异具有统计学意义(P0.05)。观察组患者CD4~+细胞(29.9%)、CD8~+细胞(28.8%)、CD11c~+细胞(0.087%)、CD123~+细胞(0.035%)明显高于其他肝病组,但NK细胞(13.3%)显著低于其他肝病组,差异具有统计学意义(P0.05)。健康组CD4~+细胞,差异具有统计学意义(26.9%)、CD8~+细胞(23.6%)、CD11c~+细胞(0.169%)、CD123~+细胞(0.064%)及NK细胞(20.7%)均显著高于其他肝病组(P0.05)。肝功能严重损伤组CD4~+、CD8~+、CD123~+细胞显著高于肝功能一般损伤组,而CD11c~+、NK细胞则显著低于肝功能一般损伤组,差异均具有统计学意义(P0.05)。血清抗线粒体抗体(AMA)-M2阴性组CD4~+、CD8~+细胞显著低于AMA-M2阳性组,而CD123~+、CD11c~+、NK细胞则显著高于AMA-M2阳性组,差异均具有统计学意义(P0.05)。结论原发性胆汁性肝硬化患者的免疫功能与肝功能都与血清AMA-M2抗体的产生有关系,其中CD11c~+与CD123~+或为影响疾病发展及AMA-M2抗体产生的主要因素。

Study on immune function and liver function injury in patients with primary biliary cirrhosis

Objective To study the changes of immune function and liver function in patients with primary biliary cirrhosis.Methods From March 2013 to March 2016 in our hospital patients with primary biliary cirrhosis 30 cases as the observation group.There were 17 patients with mild liver injury and 13 with severe hepatic dysfunction.And at the same time for the admission of 30 patients with other liver diseases in patients with liver disease as a group,30 cases underwent physical examination as healthy group were detected by flow cytometry in three groups of subjects of immunity comparison of three groups of cells,dendritic cell subsets in peripheral blood and liver function index.Results The CD4+ cells and CD8+ cells in the observation group were significantly higher than those in the healthy group(P＜0.05),while the CD11c+ cells,CD123+ cells and NK cells were significantly lower than those in the healthy group(P＜0.05).In the observation group,CD4+ cells,CD8+ cells,CD11c+ cells and CD123+ cells were significantly higher than those of other liver diseases but the NK cells were significantly lower than those of the other groups (P＜0.05).In healthy group,CD4+ cells,CD8+ cells,CD11c+ cells,CD123+ cells and NK cells were significantly higher than those of other liver disease group(P＜0.05) The CD4+,CD8+ and CD123+ cells in the liver injury group were significantly higher than those in the liver function damage group,while the CD11c+ and NK cells were significantly lower than those in the liver function group,and the difference was statistically significant(P＜0.05).The CD4+ and CD8+ cells in the AMA-M2 negative group were significantly lower than that in the AMA-M2 positive group,while those in CD123+,CD1 1c+ and NK cells were significantly higher than those in the AMA-M2 positive group,and the difference was statistically significant (P＜ 0.05).Conclusion The immune function of patients with primary biliary cirrhosis and liver function injury are associated with production of serum AMA-M2 antibodies,including CD11c+ and CD123+ or as the main factors influence the development of the disease and the AMA-M2 antibody.