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目的:探讨重型乙型肝炎患者外周血单核细胞功能变化的特点及其意义。方法:应用流式细胞术(FCM)和酶联免疫吸附法对重型肝炎患者单核细胞HLA-DR分子的表达及外周血中白细胞介素-10(IL-10)的水平进行检测,并结合临床资料加以分析。结果:与正常对照组比较,慢性乙型肝炎、肝炎肝硬化、慢性重型肝炎患者外周血单核细胞HLA-DR的表达水平逐渐下降,尤其以慢性重型肝炎患者下降最为明显;而慢性重型肝炎患者外周血中IL-10的水平则明显升高,差异均具有统计学意义(P<0.01)。相关分析表明,HLA-DR的表达水平与凝血酶原活动度呈正相关(rs=0.61,P<0.01)。慢性重型肝炎患者死亡与存活组比较,前者HLA-DR水平明显降低;而IL-10水平明显升高,差异具有统计学意义(P<0.01)。结论:外周血单核细胞HLA-DR的表达水平与慢性重型肝炎患者病情严重程度以及预后密切相关,检测外周血单核细胞HLA-DR分子水平有助于评价重型肝炎患者的免疫功能状态以及判断预后。
Objective: To investigate the changes of peripheral blood mononuclear cell function in patients with severe hepatitis B and its significance. Methods: The expression of HLA-DR in peripheral blood mononuclear cells and the level of interleukin-10 (IL-10) in patients with severe hepatitis were detected by flow cytometry (FCM) and enzyme-linked immunosorbent assay Clinical data to be analyzed. Results: Compared with the normal control group, the expression of HLA-DR in peripheral blood mononuclear cells gradually decreased in patients with chronic hepatitis B, hepatitis cirrhosis and chronic severe hepatitis, especially in patients with chronic severe hepatitis. In patients with chronic severe hepatitis The level of IL-10 in peripheral blood was significantly increased, the differences were statistically significant (P <0.01). Correlation analysis showed that the expression of HLA-DR was positively correlated with the activity of prothrombin (rs = 0.61, P <0.01). The death of patients with chronic severe hepatitis compared with the survival group, the former significantly decreased HLA-DR levels, while the IL-10 levels were significantly increased, the difference was statistically significant (P <0.01). Conclusion: The expression of HLA-DR in peripheral blood mononuclear cells is closely related to the severity and prognosis of patients with chronic severe hepatitis. Detecting the level of HLA-DR in peripheral blood mononuclear cells is helpful to evaluate the immune status and judgment of patients with severe hepatitis Prognosis.