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目的通过研究肝内促炎细胞因子 IFN-γ的表达及 IFN-γ的分泌细——T淋巴细胞的数量,以明确二者在乙型慢加急性肝衰竭(acute-on-chronic liver failure,ACLF)发病机制中的作用。方法采用免疫组化方法,分析乙型 ACLF 患者、慢性乙型肝炎(乙肝)患者及正常对照组肝内 IFN-γ的原位表达以及其分泌细胞 CD4~+T 淋巴细胞与 CD8~+T 淋巴细胞的数量。结果①乙型 ACLF 患者 IFN-γ阳性分泌细胞数均明显高于慢性乙肝患者及正常对照组,差异有统计学意义(P 均<0.001),慢性乙肝患者 IFN-γ阳性分泌细胞数明显高于正常对照组,差异有统计学意义(P<0.001);②乙型 ACLF 患者肝内CD4~+和 CD8~+T 淋巴细胞数量较慢性乙肝及正常对照组明显增加(P 均<0.001),慢性乙肝患者肝内 CD4~+和 CD8~+T 淋巴细胞数量较正常对照组明显增加(P 均<0.001);③肝内 IFN-γ阳性分泌细胞数量与 CD4~+T 淋巴细胞和 CD8~+T 淋巴细胞数量均具有明显的相关性(r=0.896和0.885,P 均<0.001)。结论乙型 ACLF 患者肝内 CD4~+T 淋巴细胞、CD8~+T 淋巴细胞数量的增加,其分泌的 IFN-γ的增加可能参与了 ACLF 的发病过程。
Objective To study the expression of pro-inflammatory cytokines IFN-γ in the liver and the number of fine-T lymphocytes secreted by IFN-γ in order to clarify their roles in the pathogenesis of acute-on-chronic liver failure ACLF) in the pathogenesis of the role. Methods The expression of IFN-γ in the liver of patients with type B ACLF, chronic hepatitis B (hepatitis B) and normal control group was analyzed by immunohistochemistry and the relationship between the expression of IFN-γ in secretory cells and CD8 + T lymphocytes The number of cells. Results ① The number of IFN-γ-positive secretory cells in patients with type B ACLF were significantly higher than those in patients with chronic hepatitis B and normal controls (P <0.001), and the number of IFN-γ-positive secretory cells in patients with chronic hepatitis B was significantly higher than that in patients with chronic hepatitis B (P <0.001). ② The numbers of CD4 ~ + and CD8 ~ + T lymphocytes in the liver of patients with ACLF were significantly higher than those in chronic hepatitis B and normal controls (all P <0.001) The number of CD4 ~ + and CD8 ~ + T lymphocytes in liver increased significantly in patients with hepatitis B (all P <0.001) compared with those in controls (P <0.001). ③ The number of intracerebral IFN-γ secreting cells was significantly correlated with CD4 ~ + T lymphocytes and CD8 ~ + T Lymphocytes were significantly correlated (r = 0.896 and 0.885, P <0.001). Conclusions The number of CD4 ~ + T lymphocytes and CD8 ~ + T lymphocytes in the liver of patients with type B ACLF increases. The increased secretion of IFN-γ may be involved in the pathogenesis of ACLF.