组合型人工肝对肝功能衰竭患者血清Th1/Th2型细胞因子的影响

目的]探讨组合型人工肝对肝功能衰竭患者血清Th1/Th2型细胞因子(IL-2、TNF-α、IFN-γ、IL-4、IL-6、IL-10)的影响。方法]采用流式细胞仪方法检测肝功能衰竭患者、肝损伤患者、正常人血清Th1/Th2型细胞因子的水平,检测肝功能衰竭患者行血浆置换(PE)、双重血浆吸附(DPMAS)、PE+DPMAS治疗前后Th1/Th2型细胞因子水平。结果]肝功能衰竭患者血清Th1/Th2型细胞因子水平与肝损伤及正常人比较差异有统计学意义(P<0.01)。PE+DPMAS组治疗前、后细胞因子水平比较均差异有统计学意义(P<0.05);PE组治疗前、后IL-2、IFN-γ、IL-6、IL-10比较差异有统计学意义(P<0.05),IL-4、TNF-α比较无差异(P>0.05);DPMAS组治疗前、后IL-6比较差异有统计学意义(P<0.01),其他细胞因子无差异(P>0.05)。PE组、DPMAS组、PE+DPMAS组治疗前Th1/Th2型细胞因子水平比较均差异无统计学意义(P>0.05),治疗后PE+DPMAS组与PE组、DPMAS组比较差异显著(P<0.01),PE组与DPMAS组比较无差异(P>0.05)。结论]肝功能衰竭患者Th1/Th2型细胞因子IL-2、TNF-α、IFN-γ、IL-4、IL-6、IL-10水平均明显高于正常人和肝损伤患者。PE+DPMAS对肝功能衰竭患者血清Th1/Th2型细胞因子的清除率明显优于单纯PE或DPMAS。

Effect of combined artificial liver on serum Th1/Th2 cytokines in patients with liver failure

Objective]To investigate the effect of combined artificial liver on serum Th1/Th 2 cytokines(IL-2,TNF-α,IFN-γ,IL-4,IL-6,IL-10)in patients with liver failure.Methods]The serum levels of Th1/Th2 cytokines were measured by flow cytometry in normal subjects,patients with liver injury and patients with liver failure.The concentrations of plasma exchange(PE),douple plasma adsorption(DPMAS)and PE+DPMAS in patients with liver failure were measured before and after combined artificial liver treatment.Results]There were significant differences on serum Th1/Th2 cytokines between the liver injury patients or normal human and liver failure patients.The cytokines levels before and after PE+DPMAS treatment were statistically significant P<0.05).There were significant differences between IL-2,IFN-γ,IL-6 and IL-10 before and after PE treatment P<0.05),there was no difference in the decline of IL-4,TNF-α(P>0.05).The decrease of IL-6 was significant in DPMAS group(P>0.01),and there was no difference in other cytokines(P>0.05).There was no statistical significance of cytokines in the PE,DPMAS,PE+DPMAS groups before the treatment(P>0.05)After the treatment,the differences of cytokines among PE+DPMAS group and PE group and DPMAS group were significant(P<0.05)There was no difference between the PE group and the DPMAS group(P>0.01).Conclusion]The concentrations of Th1/Th 2 cytokines IL-2,TNF-α,IFN-γ,IL-4,IL-6 and IL-10 in patients with liver failure are significantly higher than those in normal and liver injury groups.The clearance rate of Th1/Th2 cytokines in serum of patients with hepatic failure by PE+DPMAS was significantly higher than that of PE and DPMAS.