急性肝衰竭时外周血和肝组织中调节性T细胞表达变化的初探

目的 探讨调节性T细胞（regulatory T cells，Tregs）在急性肝衰竭外周血及肝脏中表达频数的变化。方法 选取10名急性肝衰竭患者及5名健康对照者，应用流式细胞术检测各组患者外周血中调节性T细胞表达频数的变化。将Balb/C小鼠采用数字表法随机分成急性肝衰竭1d、3d、7d组和正常对照组。模型组小鼠腹腔注射四氯化碳（carbon tetrachloride，CCL₄）矿物油1次，建立急性肝衰竭模型，对照组注射等量0.9%氯化钠注射液。生化法测定血清ALT、AST浓度，HE染色观察肝组织病理形态变化；流式细胞术分析外周血和肝组织中浸润的Tregs变化。结果 流式分析结果显示，与正常对照组相比，急性肝衰竭患者外周血Tregs表达下降（3.23±1.87 vs 6.08±1.45，P<0.05）。与对照组相比，急性肝衰竭1 d、3 d和7 d组小鼠外周血中Tregs 比例CD25⁺Foxp3⁺/CD4⁺与对照组相比呈下降趋势，而肝组织中Tregs 比例CD25⁺Foxp3⁺/CD4⁺呈升高趋势。结论 急性肝衰竭时患者和小鼠外周血中调节性T细胞呈下降趋势，而小鼠肝中浸润的CD4⁺CD25⁺Foxp3⁺调节性T细胞呈升高趋势，Tregs可能与急性肝衰竭的发生有一定相关性。

Changes of regulatory T cells in the peripheral blood and liver in acute liver failure

Objective To investigate the changes of CD4⁺CD25⁺Foxp3⁺ regulatory T cells(Tregs) in the peripheral blood and liver during acute liver failure. Methods By using flow cytometry, the peripheral blood in 10 cases of acute liver failure patients and five healthy controls were analyzed. The Balb/C mice were randomly divided into acute liver failure 1 d, 3 d, 7 d group and normal control group. The model of acute liver failure was induced by intraperitoneal injection of carbon tetrachloride(CCL₄), at the same time, the control group was injected with an equal amount of 0.9% sodium chloride. The serum was collected for detecting ALT and AST. The pathological changes of liver tissue were observed by HE staining. The changes of peripheral blood and liver tissue infiltration of Tregs were analyzed by flow cytometry. Results Compared with normal persons, the Tregs frequency in peripheral blood of acute liver failure decreased, (3.23±1.87) vs (6.08±1.45), P<0.05. Certainly, in animal experiment, the proportion of Tregs in peripheral blood of ALF, CD25⁺Foxp3⁺/CD4⁺, decreased compared to controls〔(3.80±1.59)%, (5.23±1.32)%, (3.34±1.05)% vs (5.93±0.25)%; P>0.05, P>0.05, P>0.05〕. However, the flow cytometric analysis showed that Tregs frequency, CD25⁺Foxp3⁺/CD4⁺, was higher in mouse liver of acute liver failure 1 d, 3 d and 7 d than the control group〔(3.73±1.73)%, (5.93±0.60)%, (11.16±4.65)% vs (3.33±0.99)%; P>0.05, P>0.05, P <0.05〕. Conclusion In acute liver failure, intrahepatic CD4⁺CD25⁺Foxp3⁺ regulatory T cells showed an increasing trend, while decreased in peripheral blood in mice and patients. Tregs may have a certain correlation with the incidence of acute liver failure.