原发性胆汁性胆管炎患者外周血单核细胞极化分析

目的探讨原发性胆汁性胆管炎(PBC)患者外周血单核细胞极化情况及其临床意义。方法收集PBC患者33例和健康人对照28例。用流式细胞术检测外周血单核细胞M1和M2比例及M2/M1比值,并在PBC患者与健康人对照间以及早期和晚期PBC患者之间进行比较。结果 PBC患者外周血单核细胞M2比例明显高于健康人对照(P=0.001),而M1比例及M2/M1比值在疾病组和健康人对照组之间差异无统计学意义(P0.05)。早期PBC患者外周血单核细胞M1比例明显高于中晚期PBC患者(P0.001),M2比例和M2/M1比值则明显低于中晚期患者(P0.001)。在PBC患者中,外周血单核细胞M1比例与碱性磷酸酶(ALP)和总胆汁酸(TBA)水平间相关性有统计学意义(rs=0.565、-0.394,P0.05),与丙氨酸氨基转移酶(ALT)、直接胆红素(D-Bil)和,γ-谷氨酰基转移酶(GGT)之间无相关性; M2只与ALP呈正相关,相关性有统计学意义(rs=0.588,P0.001); M2/M1比值与ALP、D-Bil、GGT及TBA间相关性均有统计学意义(P0.05)。结论 PBC发生发展过程中,单核巨噬细胞的极化状态动态变化,早期炎症阶段主要向M1极化,中晚期纤维化、硬化阶段主要向M2极化。

Analysis for polarization of peripheral monocytes in patients with primary biliary cholangitis

Abstract:Objective To explore the polarization of peripheral monocytes and clinical significance in patients with primary biliary cholangitis (PBC).Methods A total of 33 PBC patients and 28 healthy controls were recruited. Flow cytometry (FCM)was used to detect the proportions of M1 and M2 in peripheral monocytes and M2 / M1 ratio.The comparisons were conducted between PBC patients and healthy controls as well as the PBC patients between early,moderate stages and advanced stage. Results The proportion of M2 in peripheral monocytes of PBC patients was significantly higher than that of healthy controls(P = 0.001),while there was no significant difference for M1 proportion and M2 / M1 ratio between the two groups(P > 0. 05). The proportion of M1 of PBC patients in early stage was significantly higher than that of the patents in moderate to advanced stage(P<0.001),while M2 proportion and M2 / M1 ratio in early stage were lower than those of the patients in advanced stage(P<0.001).In PBC patients,the proportion of M1 was significantly correlated with the levels of alkaline phosphatase(ALP)and total bile acid(TBA)(rs =0.565,-0.394,P<0.05),but no correlated with alanine transaminase(ALT),direct bilirubin (D-Bil)and glutamyl transferase(GGT).The proportion of M2 was only significantly positively correlated with ALP (rs = 0.588,P<0.001).M2 / M1 ratio was significantly correlated with ALP,TBA,GGT and D-Bil(P<0.05). Conclusions During the development and progression of PBC,the polarization of monocytes may show dynamic change. The monocytes mainly polarize to M1 in early stage by inflammatory damage,while polarize to M2 in moderate to advanced stages by fibrosis and cirrhosis.